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Intravenous Thrombolysis in Acute Ischaemic Stroke Two Years into the COVID-19 Pandemic: A Retrospective Study Cover

Intravenous Thrombolysis in Acute Ischaemic Stroke Two Years into the COVID-19 Pandemic: A Retrospective Study

Open Access
|Jun 2024

Figures & Tables

Demographic and clinical characteristics

CharacteristicStatisticP-value
Pre-COVIDDuring COVID
Ischaemic stroke admissions, n10411087
Received IVT, all stroke diagnoses, n229186
Ischaemic stroke receiving IVT, n (%)200 (19.2)151 (13.9)<0.001
Age, years, median (IQR)77 (65-85)76 (62-85)0.434
Gender, female, n (%)113 (49.3)83 (44.6)0.374
Non-indigenous identity, n, (%)226 (98.7)184 (98.9)0.827
NIHSS score, on admission, median (IQR)6 (2-13)5 (3-9)0.313
NIHSS score, 24 hours post IVT, median (IQR)1 (1-4)1 (1-4)0.136
NIHSS score, on admission, categorised, n (%) 0.049
      No symptoms11 (4.8)8 (4.3)0.974
      Minor89 (38.9)72 (38.7)0.761
      Moderate84 (36.7)87 (46.8)0.024
      Moderate to severe17 (7.4)10 (5.4)0.400
      Severe28 (12.2)9 (4.8)0.009
mRS before stroke treatment, median (IQR)0 (0-1)0 (0-1)0.327
mRS on discharge, median (IQR)1 (1-4)1 (1-4)0.647
mRS on discharge, cateogorised, n (%) 0.522
      Score 0-1121 (52.8)101 (54.3)0.766
      Score 2-332 (14.0)19 (10.2)0.246
      Score 4-556 (24.5)53 (28.5)0.419
      Score 620 (8.7)13 (7.0)0.655
Time: symptom onset to ED, minutes, median (IQR)86 (62-130)107 (74-166)0.004
Time: Door to CT scan, minutes, median (IQR)19 (13-29)22 (16-32)0.007
Time: Door to Needle (IVT), minutes, median (IQR)59 (41-78)65 (53-85)0.002
Time: onset to needle (IVT), minutes, median (IQR)160 (120-205)188 (144-240)<0.001
Length of stay: ED, minutes, median (IQR)157 (113-202)173 (131-216)0.011
Length of stay: hospital, days, median (IQR)5 (3-8)5 (3-9)0.095
Discharge stroke diagnosis, n (%) 0.063
      Ischaemic200 (87.3)151 (81.2)0.084
      Transient ischaemic attack10 (4.4)6 (3.2)0.548
      Stroke mimic (Vilela, 2017)19 (8.3)29 (15.6)0.021

j_ajon-2024-003_tab_002

VariablesDescription

Demographics:

Age

Gender

Indigenous identity

Age of patients in years

Gender of patients (female, male, binary)

Indigenous identity of patient (aboriginal/torres strait islander, non-aboriginal/torres strait islander)

Stroke presentation:

Presentation

Admission

Patient presented to hospital with stroke symptoms

Patients admitted to the acute stroke unit

NIHSS

Stroke severity scale (admission, 24 hours post IVT)

No symptoms - 0

Minor = 1-4

Moderate = 5-15

Moderate to severe = 16-20

Severe = 21-42

mRS

Patient function (pre-stroke treatment, discharge)

0 = no symptom

1 = No significant disability. Able to carry out all usual activities, despite some symptoms

2 = Slight disability. Able to look after own affairs without assistance, but unable to carry out all previous activities

3 = Moderate disability. Requires some help, but able to walk unassisted

4 = Moderately severe disability. Unable to attend to own bodily needs without assistance, and unable to walk unassisted

5 = Severe disability. Requires constant nursing care and attention, bedridden, incontinent

6 = Dead

Measure (Time in minutes):

Symptom to ED time

Door to CT time

Door to Needle time

Length of Stay

Time from onset of first symptoms to presentation to ED

Time patient spent in ED before CT imaging

Time from patient presentation to hospital to administration of bolus dose of alteplase

Patient length of stay (ED in minutes, hospital in days)

Diagnosis

Ischaemic Stroke

Neurological symptoms due to the effect of decreased blood flow to particular areas of the brain that correlate with examination findings and infarct on the diffusion-weighted Magnetic Resonance Imaging (MRI)
TIATemporary focal neurological symptoms resulting from cerebral ischaemia that is not associated with infarction on diffusion-weighted MRI
Stroke mimicNon-vascular conditions that present with an acute neurological deficit simulating acute ischaemic stroke
DOI: https://doi.org/10.21307/ajon-2024-003 | Journal eISSN: 2208-6781 | Journal ISSN: 1032-335X
Language: English
Page range: 29 - 38
Published on: Jun 1, 2024
In partnership with: Paradigm Publishing Services
Publication frequency: 2 issues per year

© 2024 Sheila Jala, Carin Bertmar, Margaret Fry, Rosalind Elliott, Susan Day, Elizabeth O’Brien, Miriam Priglinger-Coorey, Martin Krause, published by Australasian Neuroscience Nurses Association
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.