Predicting abnormal coagulation in ischemic stroke: reducing delay in rt-PA use.
Normal prothrombin time (PT) and partial thromboplastin time (PTT) are recommended for administration of recombinant tissue-plasminogen activator (rt-PA) in stroke, but waiting for results can delay use. We examined the charts of 365 stroke patients to assess predetermined risk factors associated with elevated PT/PTT. Elevated PT/PTT can be predicted in patients taking warfarin or heparin/heparinoid or on hemodialysis, according to emergency department triage, with 100% sensitivity and 94.7% specificity. These results could be applied to rt-PA candidates and reduce potential delays.
Gottesman
Rebecca F
RF
Cerebrovascular Division, Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Alt
Janice
J
Wityk
Robert J
RJ
Llinas
Rafael H
RH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000032:analysis / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D002545:Brain Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D020147:Coagulation Protein Disorders / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D006493:Heparin / Q000032:analysis / Q000097:blood; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D017093:Liver Failure / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects; D006435:Renal Dialysis / Q000009:adverse effects; D020521:Stroke / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000009:adverse effects; D014218:Triage / Q000379:methods; D014859:Warfarin / Q000032:analysis / Q000097:blood
D000925:Anticoagulants; D011994:Recombinant Proteins; D014859:Warfarin; D006493:Heparin; D010959:Tissue Plasminogen Activator