1.Thrombolysis in ischaemic stroke in rural North East Thailand by neurologist and non-neurologists
Kannikar Kongbunkiat ; Narongrit Kasemsap ; Somsak Tiamkao ; Verajit Chotmongkol ; Kittisak Sawanyawisuth ; Pawut Mekawichi ; Kasemsin Pavakul ; Pisit Soison ; Janhom Jattawanin ; Panadda Kaitchanon ; Weera Yaowapruek ; Arkom Arayawichanon ; Thanun Thanwiset
Neurology Asia 2016;21(4):325-331
Background & Objective: Acute ischemic stroke (AIS) has been shown to be effectively treated
with thrombolytic therapy. Thailand and other developing countries have limited stroke specialists to
prescribe this treatment. Data regarding stroke outcomes in AIS patients who received thrombolytic
therapy prescribed by neurologists compared with non-neurologists are limited. Methods: This was a
large, multicenter, retrospective study conducted in 9 hospitals across the northeastern part of Thailand.
The inclusion criteria were AIS patients who were admitted and treated with thrombolytic therapy
between January 2010 and December 2012. Patients were categorized into two groups by physician
specialty; neurologist and non-neurologist. Clinical outcomes and in-hospital mortality were compared
between the groups. Results: There were 915 AIS patients who participated in the study; 175 patients
were treated by the non-neurologists (19.1%). The mean age of all patients was 64 years and 55.1%
were men. The median onset to needle time in both groups were similar at 180 minutes. The National
Institutes of Health Stroke Scale (NIHSS) at discharge were significantly higher in neurologist group
than non-neurologist group (NIHSS 6 vs 3, p value 0.03). The in-hospital mortality was also higher
in neurologist group (9.5% vs 4.0%; p value 0.02).
Conclusions: Non-neurologists may be able to thrombolyze AIS patients safely and effectively.
Stroke
;
Thrombolytic Therapy
Result Analysis
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