Abstract|Stroke 2| Volume 357, SUPPLEMENT 1, e103, October 15, 2015

Temporal trends of intravenous thrombolysis in acute ischemic stroke patients at a tertiary care center in northern India

      Background: Acute ischemic stroke (AIS) is chiefly time dependent treatable cause of morbidity and mortality. Despite increasing stroke incidence in developing countries, increasing stroke thrombolysis rates have not been documented.
      Aims: To determine trends in patient characteristics and rates of tPA use in AIS patients in a tertiary care center in northern India.
      Methods: All AIS patients presenting within 8 h of symptoms onset from 2010–2014 were enrolled from hospital stroke registry and analyzed for various measures of IV thrombolysis.
      Results: 608 AIS patients presented within 8 h of symptoms onset. Out of 608 patients, 157 (25.82%) patients received intravenous thrombolysis (IVT) with r-tPA. Patient’s onset-to-door time was ≤2 h in 58.60%, ≤3 h in 25.48% and ≤4.5 h in 15.29%. A substantial change in onset-to-door time and IVT was seen over 4 years. IVT rates in ≤ 2 h of symptom onset increased from 22.2% to 25% and in ≤3 h increased from 38.89% to 43.75%. Door-to-CT time (median 25 versus 14 min, P = 0.027) and door-to-needle time (median 75 versus 62 min, P = 0.011) improved, with 64.5% of tPA-treated patients getting imaged ≤25 min after arrival. Post IVT, hemorrhage was noticed in 17 (10.82%) patients. Median NIHSS at presentation was 12 while favorable mRS (0–2) at 3 months was seen in 48.85%.
      Conclusions: Encouraging trends of increasing rates of IV tPA use along with improving quality in thrombolysis over the years is seen in a public sector hospital. This may be indicative of increasing use of IV tPA in developing countries like India.