title: Intravenous thrombolysis for acute cerebral ischemia in Belgrade, Serbia: comparison with Lille, France.
abstract: BACKGROUND
  Worse socioeconomic situation is associated with worse outcomes in stroke cases. Whether it also influences outcomes in patients treated with intravenous thrombolysis remains unknown. The aim of this study was to test the hypothesis that outcomes are less favorable in patients treated with intravenous thrombolysis in Belgrade, Serbia, than in Lille, France.
  
  
  METHODS
  We compared outcomes at day 7 and month 3, between 123 consecutive stroke patients treated with intravenous thrombolysis in Belgrade and 273 in Lille.
  
  
  RESULTS
  At month 3, there was no significant difference between Belgrade and Lille in patients' excellent outcomes [modified Rankin Scale 0-1; 49.6 vs. 45.4%, odds ratio (OR): 1.21, 95% confidence interval (CI): 0.79-1.86] or in death (11.4 vs. 16.1%, OR 0.67, 95% CI: 0.35-1.27). However, compared with a subgroup of age-matched patients from Lille, Belgrade patients tended to have worse outcomes. Patients from Belgrade were 16 years younger (p < 0.0001), more likely to be men (OR 2.40, 95% CI: 1.52-3.78), and more likely to be smokers (OR 2.24, 95% CI: 1.43-3.51). Also, a trend for a slightly higher rate of symptomatic hemorrhagic transformation was registered in this group (7.3 vs. 3.3%, OR 2.32, 95% CI: 0.90-5.99). In Belgrade, patients arrived 27 min earlier to the hospital (p < 0.0001), but their door-to-needle time was 37 min longer (p < 0.0001). Compared with a subgroup of age-matched patients from Lille, they tended to have worse outcomes.
  
  
  CONCLUSIONS
  Intravenous thrombolysis-treated stroke patients in Belgrade have similar outcomes and rates of complications as those from Lille.
authors.affiliation: Institute of Neurology, School of Medicine, Clinical Centre of Serbia, Dr Subotica 6, Belgrade, Serbia. visnja@beotel.rs
authors.forename: Visnja
authors.initials: V
authors.lastname: Bogosavljevic
authors.forename: Marie
authors.initials: M
authors.lastname: Bodenant
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Beslac-Bumbasirevic
authors.forename: Charlotte
authors.initials: C
authors.lastname: Cordonnier
authors.forename: Dejana R
authors.initials: DR
authors.lastname: Jovanovic
authors.forename: Maja
authors.initials: M
authors.lastname: Budimkic
authors.forename: Didier
authors.initials: D
authors.lastname: Leys
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D005602:France; D006801:Humans; D007275:Injections, Intravenous / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D016017:Odds Ratio; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D010959:Tissue Plasminogen Activator