@article{eissa2013hospital,
  title = {Hospital Utilization of Thrombolysis for the Treatment of Acute Ischaemic Stroke},
  author = {Ashraf Eissa and Ines Krass and Christopher Levi and Jonathan Sturm and Rabsima Ibrahimand Beata Bajorek},
  year = 2013,
  url = {https://ibimapublishing.com/articles/RNIJ/2013/255837/},
  journal = {Research in Neurology: An International Journal},
  volume = 2013 (2013),
  pages = 10,
  doi = 10.5171/2013.255837,
  abstract = {Background: Thrombolysis is the only available evidence-based pharmacotherapy for acute ischaemic stroke (AIS); however, its utilization is reported to be low.  Aims: The aim of this study is to audit the utilization of thrombolysis for the treatment of acute ischaemic stroke in hospital practice. Methods: A retrospective, cross-sectional study was conducted in five metropolitan hospitals comprising two tertiary referral centers and three district hospitals. Patients discharged with a principal diagnosis of AIS over a 12-month time period (July 2009-July 2010) were identified, and the medical record of a systematically chosen samples were reviewed. Results: A total of 521 records (48.8% females, median age 77 [IQR 67-85] years) from the 1261 AIS patients were reviewed. Approximately one tenth (9.2%) of AIS patients were deemed to be potentially eligible for thrombolysis according to the most recent guidelines, of which 50.0% actually received the treatment, although this proportion varied between hospitals: 30.0% (TRC-1), 73.3% (TRC-2), 0% (DH-1), 11.1% (DH-2) and 90.0% at (DH-3). The overall utilization of thrombolysis was 4.6% in the AIS patient sample which translates to 14.7% of the patients arriving within the time-window of 4.5 hours. Factors associated with the utilization of thrombolysis were: age <80 years (P=0.04), lack of previous history of stroke or TIA (P=0.02), shorter onset-to-arrival time (P=0.01), and shorter arrival-to-neuroimaging time (P<0.01).  Conclusion: The proportion of thrombolysis-eligible patients appears low, and is mainly due to delayed patient presentation. Furthermore, there is a wide variation in the utilization of thrombolysis between different hospitals with likely significant underutilization in some hospitals.},
  keywords = {Tissue Plasminogen Activator (tPA), Thrombolysis, Stroke, Cerebrovascular accident},
  note = Article ID: 255837
}