In:
Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 1 ( 2009-01), p. 30-34
Abstract:
Background and Purpose— The Ministry of Health, Labor, and Welfare of Japan approved the use of recombinant tissue-type plasminogen activator (rt-PA) for the treatment of acute ischemic stroke in October 2005. The impact of the regulatory approval of rt-PA on the processes of acute stroke management was examined. Methods— A prospective, multicenter, observational study was conducted between December 2004 and December 2005 in 84 Japanese institutes, including 24 institutes with a stroke unit. We enrolled 4620 consecutive patients who were hospitalized within 72 hours after the onset of completed ischemic stroke; 1089 of them were hospitalized after rt-PA was approved. The patients’ characteristics and the processes of stroke management were compared before and after rt-PA approval. Results— Age, gender, stroke subtype, time from onset to hospital visit, and National Institutes of Health Stroke Scale score on admission were similar between the 2 periods. With approval, the percentage of patients treated with intravenous rt-PA therapy increased from 0.7% to 2.6% ( P 〈 0.001). The rate increased from 0.9% to 5.2% in institutes with a stroke unit ( P 〈 0.001) but did not increase in other institutes ( P =0.587). Within 24 hours of stroke onset, conventional MRI ( P =0.003), diffusion-weighted MRI ( P 〈 0.001), magnetic resonance angiography ( P =0.001), carotid ultrasound ( P =0.004), measurement of prothrombin time or activated partial thromboplastin time ( P =0.034), and measurement of blood sugar ( P =0.015) were performed more frequently after rt-PA approval. Conclusions— The present results indicate that the approval of intravenous rt-PA therapy resulted in dramatic changes in the processes of management for acute stroke patients.
Type of Medium:
Online Resource
ISSN:
0039-2499
,
1524-4628
DOI:
10.1161/STROKEAHA.108.524942
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2009
detail.hit.zdb_id:
1467823-8
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