Tissue plasminogen activator use up, but patients taking longer to get to the hospital after stroke
FRIDAY, Feb. 3 (HealthDay News) -- Stroke victims are not getting to the hospital any faster than they did in 2005, according to a study presented at the American Heart Association's International Stroke Conference, held from Feb. 1 to 3 in New Orleans.
Xin Tong and Mary G. George, M.D., M.S.P.H., from the U.S. Centers for Disease Control and Prevention in Atlanta, studied 114,420 patients with acute ischemic stroke from January 2005 to December 2010 to assess factors associated with receipt of tissue plasminogen activator (tPA) within three hours of time last known to be well (LKW).
The researchers found that documentation of LKW increased over the study period (45.3 versus 46.6 percent; P < 0.001). From 2005 to 2010, there was a significant decrease in the patients arriving within two hours of LKW (40.0 versus 35.2 percent), and a significant increase in the percent who arrived more than 4.5 hours after LKW (39.1 versus 43.9 percent). Use of emergency medical services (EMS) decreased over the study period (49.9 versus 49.1 percent; P < 0.001). Use of any tPA increased significantly, from 6.4 percent to 9.2 percent. Factors significantly associated with receipt of intravenous tPA included use of EMS (adjusted odds ratio [aOR], 3.2), minority status (aOR for black, 1.22 and aOR for other non-white, 1.49), age less than 65 years (OR, 1.29), and independent ambulation prior to stroke (OR, 2.12).
"Little or no improvement in knowing LKW, use of EMS, and sooner arrival for acute stroke demonstrates the continued need for public education on signs, symptoms, and actions to take for acute stroke," the authors write.
Abstract No. 191