[Estimation of patient eligibility for thrombolysis in acute ischaemic stroke based on a hospital stroke registry in Warsaw].
OBJECTIVE
Thrombolysis for acute ischaemic stoke was introduced and licensed in Poland in 2003. The aim of the study was to assess the potential eligibility of patients for intravenous recombinant tissue plasminogen activator (rt-PA). We also investigated whether widespread information about stroke and organisational changes in the 2nd Department of Neurology influenced eligibility and the number of treated patients.


METHODS
An analysis of the 2nd Department of Neurology of the Institute of Psychiatry and Neurology database of stroke patients admitted in the years 1995-2003 and 2003-2005 was performed. Eligibility for rt-PA treatment was assessed using the criteria outlined by the SITS (Safe Implementation of Thrombolysis in Stroke) protocol. The number of patients eligible for thrombolysis was estimated and then compared with the number of treated patients.


RESULTS
A total of 1541 patients with ischaemic stroke were admitted between 1 June 1995 and 1 November 2003, 18.7% within 2 hours of onset, 78% aged under 80. 4.6% of patients were found eligible for rt-PA. 552 ischaemic stroke patients were admitted between 1 November 2003 and 30 September 2005, 19.2% within 2 hours from onset, 71.6% under 80 years old. 6.9% were eligible for rt-PA, and 8.6% were treated.


CONCLUSIONS
Age and time from onset to admission were the most common exclusion criteria. The number of actually treated patients was higher than estimated. After providing the information about stroke symptoms there was a trend in decreasing time from onset to admission. Organizational changes increased the number of treated patients.
Kobayashi
Adam
A
II Klinika Neurologii, Instytut Psychiatrii i Neurologii, ul. Sobieskiego 9, 02-957 Warszawa.
Sarzyńska-Długosz
Iwona
I
Niewada
Maciej
M
Skowrońska
Marta
M
Członkowska
Anna
A
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004608:Eligibility Determination / Q000706:statistics & numerical data*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006753:Hospital Records / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data; D018579:Patient Selection; D011044:Poland; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator