Article

The benefits of thrombolysis in patients presenting with
acute ischemic stroke (IS) are highly time-dependent. The aim of our study was to
evaluate the clinical benefit, after 3 months, of an intrahospital mobile
thrombolysis team (MTT) for thrombolysis in IS.
METHODS: A total of
95 consecutive patients treated with IV tPA for acute IS at the neurology
department of Rouen University Hospital between 1 January and 31 December 2015
were retrospectively identified. Patients who had benefited from mechanical
thrombectomy or hemicraniectomy were excluded. The study compared 33 patients who
had benefited from our MTT (thrombolysis whatever the location and as soon as
possible by a specific nurse) with 62 patients treated in the usual way
(thrombolysis only at the stroke unit). Management timescales, inhospital and
3-month clinical outcomes, and imaging data were also compared between the two
groups. RESULTS: Demographic data and factors known to influence the clinical
course after thrombolysis were similar between the two groups (P>0.05). However,
use of the MTT allowed significant decreases in the median onset-to-treatment
(OTT) time of 26min and median door-to-needle (DTN) time of 27min (P<0.001). The
proportion of patients with a DTN time<60min was higher in the MTT group than in
the usual care (UC) group: 64% vs. 14%, respectively (P<0.001), according to
American Heart Association/American Stroke Association guidelines. Although there
was a smaller proportion of negative 3-month outcomes (modified Rankin Scale
score: 6; 6% vs. 16%) and a larger proportion of highly favorable 3-month
outcomes (mRS score: 0-1;
79% vs. 64%) in the MTT vs. UC groups, respectively,
these differences were not statistically significant (P>0.05).
DISCUSSION/CONCLUSION: Use of an MTT is a simple way to reduce thrombolysis
delays, and the present results encourage us to improve the system to make it
even more effective and available for all patients.
CI - Copyright (c) 2017 Elsevier Masson SAS. All rights reserved.

Langue : ANGLAIS