Trends in thrombolytic use for ischemic stroke in the United States
- 23 June 2010
- journal article
- research article
- Published by Wiley in Journal of Hospital Medicine
- Vol. 5 (7), 406-409
- https://doi.org/10.1002/jhm.689
Abstract
BACKGROUND:Although recombinant tissue plasminogen activator (tPA) improves outcomes from ischemic stroke, prior studies have found low rates of administration. Recent guidelines and regulatory agencies have advocated for increased tPA administration in appropriate patients, but it is unclear how many patients actually receive tPA.OBJECTIVE:To determine whether national rates of tPA use for ischemic stroke have increased over time.METHODS:We identified all patients with a primary diagnosis of ischemic stroke from years 2001 to 2006 in the National Hospital Discharge Survey (NHDS), a nationally representative sample of inpatient hospitalizations, and searched for procedure codes for intravenous thrombolytic administration. Clinical and demographic factors were obtained from the survey and multivariable logistic regression used to identify independent predictors associated with thrombolytic use.RESULTS:Among the 22,842 patients hospitalized with ischemic stroke, tPA administration rates increased from 0.87% in 2001 to 2.40% in 2006 (P < 0.001 for trend). Older patients were less likely to receive tPA (adjusted odds ratio [OR] and 95% confidence interval [CI]; 0.4 [0.3‐0.6] for patients ≥80 years vs.Keywords
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