title: Stroke physician versus stroke neurologist: can anyone thrombolyse?
abstract: OBJECTIVE
  The aim of this study is to compare the outcomes of thrombolysis under standard clinical settings between subjects treated by a stroke neurologist versus those treated by a non-neurologist stroke physician.
  
  
  METHODS
  Single-centre, observational cohort study of subjects thrombolysed in a calendar year, stratified according to the physician type authorising thrombolysis. Endpoints measured include proportion of subjects with symptomatic intracranial haemorrhage, door-to-needle time, change in National Institute of Health Stroke Scale and discharge destination.
  
  
  RESULTS
  Forty-nine subjects with a mean age 76 ± 16 years underwent thrombolysis, 21 were under the care of a stroke neurologist and 28 by a non-neurologist stroke physician. No symptomatic intracranial haemorrhages were observed. There was no difference in terms of door-to-needle time, proportion of individuals with haemorrhagic transformation, mortality or discharge destination between the two groups.
  
  
  CONCLUSIONS
  Due to the single-centre, observational nature of this study, the equivalent outcomes between those thrombolysed by a stroke neurologist versus those thrombolysed by a stroke physician must be interpreted with caution pending further studies. Nevertheless, in the current setting, no signal for harm has been detected. This study is unique as it is the first to our knowledge comparing outcomes between a neurologist and non-neurologist following thrombolysis.
authors.affiliation: Flinders Comprehensive Stroke Centre, Flinders University of South Australia and Flinders Medical Centre, Adelaide, South Australia, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Lee
authors.forename: A
authors.initials: A
authors.lastname: Gaekwad
authors.forename: M
authors.initials: M
authors.lastname: Bronca
authors.forename: L
authors.initials: L
authors.lastname: Cheruvu
authors.forename: O
authors.initials: O
authors.lastname: Davies
authors.forename: C
authors.initials: C
authors.lastname: Whitehead
authors.forename: M
authors.initials: M
authors.lastname: Agzarian
authors.forename: C
authors.initials: C
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002543:Cerebral Hemorrhage / Q000139:chemically induced / Q000175:diagnosis; D015331:Cohort Studies; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009462:Neurology / Q000379:methods / Q000592:standards*; D010819:Physician's Role; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000009:adverse effects / Q000379:methods / Q000592:standards*
chemical_list: D005343:Fibrinolytic Agents
keywords: stroke; stroke neurologist; stroke physician; thrombolysis