title: An analysis of outcomes of emergency physician/department-based thrombolysis for stroke.
abstract: BACKGROUND
  Stroke thrombolysis is strongly supported as an effective therapy for selected cases of early stroke. The absence of 24 h stroke specialists in district general hospitals (DGHs) has led to the suggestion that regional hyper-acute stroke centres should be developed. This paper describes a cooperative model that uses the skills already present in a DGH to deliver a thrombolysis service initiated in the emergency department by the emergency physicians, and describes the outcomes of that service in comparison with the SITS-MOST trial.
  
  
  METHODS
  The outcomes of all stroke patients thrombolysed at Scarborough DGH from 2004 to January 2009 were reviewed. Outcome was defined using a three-part scale. Data at Scarborough DGH were compared with data from the SITS-MOST European-wide study of stroke thrombolysis.
  
  
  RESULTS
  Data were available for 98 of 110 patients thrombolysed during the study period. Fifty (51%) had a good outcome, seven (8%) had partial resolution of their symptoms, and 41 (42%) showed no improvement or deterioration. These outcomes were comparable to those in the European database.
  
  
  CONCLUSIONS
  Stroke thrombolysis can be effectively delivered in a non-specialist (a non-hyper-acute stroke centre) DGH in the UK. An audit of cases completed describes complications seen.
authors.affiliation: Emergency Department, Scarborough Acute Trust, Woodlands Drive, Scarborough, North Yorkshire, UK. andrew.volans@acute.sney.nhs.uk
authors.forename: A P
authors.initials: AP
authors.lastname: Volans
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004636:Emergency Service, Hospital; D004739:England; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006769:Hospitals, General; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy
chemical_list: D005343:Fibrinolytic Agents