Background: Stroke is a leading cause of stroke and disability worldwide.
Recombinant tissue plasminogen activator (rTPA) is licensed for treatment of acute stroke in the early hours after symptoms onset. But its sill underutilized.
Small communities and hospitals may benefit from faster access to care. A compact and cohesive stroke team and shorter in hospital distance may result in better symptoms door to door to needle time and therefore in better clinical outcome
Methods: We collected data from 334 patients with acute stroke who were treated with rTPA from 2003 to 2013 in two small Italian Hospitals.
The primary endpoint was a modified Rankin scale at discharge of 0–1 favorable outcome at day 90. We will use scale 0–2 for a sensitivity analysis.
Secondary efficacy endpoints will be symptoms to door and door to needle time. Safety endpoints comprise overall mortality and symptomatic intracranial hemorrhage at 90 days.
Results: 334 patients, 159 female ad 175 male were treated with rTPA. The mean age was 71.3 ± 12.4 with a range from 93 a median score of 90.24 and a median score of 73.5 NIHSS at time 0 = 13.8 ± 5.1, Rankin at 3 months 1.7 ± 1.7 Fatal hemorrhage 1 (0.3%) These results were comparable to the international SITS Registry for thrombolytic.
Conclusion: thrombolytic therapy for acute stroke in small community hospital can result in an outcome comparable to that of larger center.
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© 2015 Published by Elsevier Inc.