In-hospital stroke treated with intravenous tissue plasminogen activator.
OBJECTIVE
In-hospital strokes (IHSs) are potential candidates for thrombolysis. We analyzed the treatment procedures, safety, and efficacy of intravenous tissue plasminogen activator (IV-tPA) in IHSs compared with out-of-hospital strokes (OHSs).


METHODS
This study was based on a multicenter prospective registry of patients treated with IV-tPA divided into IHSs and OHSs. We recorded intrahospital delays and stroke outcomes.


RESULTS
Among 367 patients treated with IV-tPA, 30 were IHSs. Baseline characteristics were similar except for a greater proportion of diabetes (36.7% vs 17.5%, P=0.01), cardiac failure (16.7% vs 5.3%, P=0.014), and atrial fibrillation (33.3% vs 17.5%, P=0.034) in IHSs than OHSs. In-hospital delays were significantly longer in IHSs for door-to-computed tomography time (39.5+/-18.7 vs 22.6+/-19.7 minutes, P<0.0001) and computed tomography-to-treatment time (92.0+/-26.1 vs 65.4+/-25.8 minutes, P<0.0001). No differences were observed in safety or efficacy.


CONCLUSIONS
In-hospital procedures for thrombolysis proceed more slowly in IHSs than in OHSs. Thrombolysis is safe and efficient in IHS.
Masjuan
Jaime
J
Unidad de Ictus, Servicio de Neurología, Hospital Ramón y Cajal, Carretera de Colmenar Km 9.1, 28034 Madrid, Spain. jmasjuan.hrc@salud.madrid.org
Simal
Patricia
P
Fuentes
Blanca
B
Egido
José Antonio
JA
Díaz-Otero
Fernando
F
Gil-Núñez
Antonio
A
Novillo-López
Maria Elena
ME
Díez-Tejedor
Exuperio
E
Alonso de Leciñana
María
M
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D042241:Early Diagnosis; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D006333:Heart Failure / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011787:Quality of Health Care / Q000639:trends; D012042:Registries; D020521:Stroke / Q000188:drug therapy* / Q000451:nursing; D015912:Thrombolytic Therapy / Q000379:methods / Q000706:statistics & numerical data*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator