Ineligibility of Intravenous Thrombolysis among Activated Stroke Fast Track Patients of Khon Kaen Hospital
Keywords:
avoidable factor, ineligibility, intravenous thrombolysis, stroke fast track, unavoidable factorAbstract
Background and objective: The primary objective was to identify factors responsible for thrombolytic ineligibility. The secondary one was to determine the ratio of stroke type and stroke-mimic conditions, and to evaluate achievement of stroke fast track.
Materials and Methods: We collected all recruited stroke fast track patient data including age, gender, occupation, comorbidity, current medication, symptom onset or last-seen-normal time, vital signs, National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), hospital arrival time, time of neurologist consultation, arrival time of neurologist, time of laboratory register and result, time of brain computed tomography (CT) request, performance and interpretation, alteplase administration and its contraindication. Statistical analysis was done appropriately.
Results: There were 181 stroke fast track candidates. One patient was referred to another tertiary hospital because of unavailable brain CT, then 180 patients were enrolled. There were 9 (5.0%) patients of stroke-mimic condition, 39 (19.44%) patients of hemorrhagic stroke, and 136 (75.56%) patients of acute ischemic stroke. Of these 136 patients, 50 (36.76%) cases received thrombolytic therapy and there were 17 (34.0%) cases had got alteplase within target (60 minutes). The avoidable ineligible factors were 2 (2.33%) delayed laboratory report, 1 (1.16%) missed neurologist consultation, delayed Door-to-Neurologist time and no decision making relative. The other unavoidable factors were 74 (86.05%) protocol exclusion, 5 (5.81%) inaccurate onset, 1 (1.16%) denial and 1 (1.16%) high risk brain CT.
Conclusion: The highlights were that most of stroke fast track patients were thrombolytic candidates. One third of them were excluded because of both avoidable and unavoidable reasons that could be resolved by further systemic development.
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ข้อความภายในบทความที่ตีพิมพ์ในวารสารสมาคมโรคหลอดเลือดสมองไทยเล่มนี้ ตลอดจนความรับผิดชอบด้านเนื้อหาและการตรวจร่างบทความเป็นของผู้นิพนธ์ ไม่เกี่ยวข้องกับกองบรรณาธิการแต่อย่างใด การนำเนื้อหา ข้อความหรือข้อคิดเห็นของบทความไปเผยแพร่ ต้องได้รับอนุญาตจากกองบรรณาธิการอย่างเป็นลายลักษณ์อักษร ผลงานที่ได้รับการตีพิมพ์ในวารสารเล่มนี้ถือเป็นลิขสิทธิ์ของวารสาร
