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001-es BibID:	BIBFORM042545
Első szerző:	Mikulík, Robert
Cím:	Factors influencing in-hospital delay in treatment with intravenous thrombolysis / Robert Mikulík, Pavla Kadlecova, Anna Czlonkowska, Adam Kobayashi, Miroslav Brozman, Victor Švigelj, Laszlo Csiba, Klara Fekete, Janika Kõrv, Vida Demarin, Aleksandras Vilionskis, Dalius Jatuzis, Yakup Krespi, Niaz Ahmed
Dátum:	2012
ISSN:	0039-2499
Megjegyzések:	Background: Shortening door-to-needle time (DNT) for the thrombolytic treatment of strokecan improve treatment efficacy by reducing onset-to-treatment time. The goal of our studywas to explore the association between DNT and outcome and to identify factors influencingDNT to better understand why some patients are treated late.Methods: Prospectively collected data from the Safe Implementation of Treatments in Stroke-East registry (SITS-EAST: nine Central and Eastern European countries) on all patientstreated with thrombolysis between February/2003 and February/2010 were analyzed. Multiplelogistic regression analysis was used to identify predictors of DNT?60 minutes.Results: Altogether, 5563 patients were treated with thrombolysis within 4.5 hours ofsymptom onset. Of these, 2097 (38%) had DNT?60 minutes. In different centers, theproportion of patients treated with DNT?60 minutes ranged from 18 to 84% (p<0.0001).Patients with longer DNT (in 60 minute increments) had less chance of achieving modifiedRankin scale 0-1 at 3 month (adjusted OR 0.86, 95%CI 0.77 to 0.97). DNT?60 minutes wasindependently predicted by younger age (in 10 year increments, OR 0.92, 95%CI 0.87 to0.97), NIHSS score 7-24 (OR 1.44, 95%CI 1.2 to 1.7), onset-to-door time (in 10 minuteincrements, OR 1.19, 95%CI 1.17 to 1.22), treatment center (p<0.001), and country(p<0.001).Conclusions: Thrombolysis of patients with older age and mild or severe neurological deficitis delayed. The perception that there is sufficient time before the end of thrombolytic windowalso delays treatment. It is necessary to improve adherence to guidelines and to treat patientssooner after arrival to hospital.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Stroke. - 43 : 6 (2012), p. 1578-1583. -
További szerzők:	Kadlecova, Pavla Czlonkowska, Anna Kobayashi, Adam Brozman, Miroslav Švigelj, Victor Csiba László (1952-) (neurológus, pszichiáter) Fekete Klára (1978-) (neurológus) Kõrv, Janika Demarin, Vida Vilionskis, Aleksandras Jatuzis, Dalius Krespi, Yakup Ahmed, Niaz
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