Intravenous thrombolysis in the emergency department for the treatment of acute ischaemic stroke
2008

Thrombolysis for Acute Ischaemic Stroke in the Emergency Department

Sample size: 52 publication Evidence: moderate

Author Information

Author(s): Semplicini A, Benetton V, Macchini L, Realdi A, Manara R, Carollo C, Parotto E, Mascagna V, Leoni M, Calò L A, Pessina A C, Tosato F

Primary Institution: University of Padua Medical School and Azienda Ospedaliera

Hypothesis

Can intravenous rt-PA treatment in the emergency department improve outcomes for acute ischaemic stroke patients when a stroke unit is not available?

Conclusion

Intravenous rt-PA administration in the ED is an effective organisational solution for acute ischaemic stroke when an SU is not established.

Supporting Evidence

  • 20 patients (38%) improved neurologically after 24 hours.
  • 30 patients (58%) improved after one week.
  • 22 patients (43%) had a favourable outcome at 3 months.
  • The 3-month mortality rate was 12%.
  • Symptomatic cerebral haemorrhage was observed in two patients (4%).

Takeaway

This study shows that giving a special medicine to stroke patients in the emergency room can help them get better, even if there isn't a special stroke unit nearby.

Methodology

Patients were treated with intravenous rt-PA in the ED and then transferred to a semi-intensive stroke care unit for follow-up.

Potential Biases

Patient selection was limited to those assessed by authorized stroke team investigators.

Limitations

The study had a small sample size and was conducted by a limited number of stroke team investigators.

Participant Demographics

The mean age of participants was 66 years, with 42% being female.

Digital Object Identifier (DOI)

10.1136/emj.2007.053033

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