Utilization and outcome of thrombolytic therapy for acute stroke in Pakistan

Our objective was to identify the outcome of patients treated with tissue plasminogen activator (r-tPa) in Pakistan and compare these data to available regional and international data. The charts of all patients treated with r-tPa for acute stroke at two centers in Pakistan (Aga Khan University, Kar...

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Bibliographic Details
Published in:Neurological sciences 2010-04, Vol.31 (2), p.223-225
Main Authors: Wasay, Mohammad, Barohi, Hazim, Malik, Abdul, Yousuf, Adnan, Awan, Safia, Kamal, Ayeesha K.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Brief Communication
Developing Countries
Female
Guideline Adherence
Humans
Intracranial Hemorrhages - chemically induced
Intracranial Hemorrhages - mortality
Male
Medicine
Medicine & Public Health
Middle Aged
Neurology
Neuroradiology
Neurosciences
Neurosurgery
Pakistan
Psychiatry
Retrospective Studies
Stroke
Stroke - drug therapy
Stroke - mortality
Thrombolytic Therapy - adverse effects
Thrombolytic Therapy - methods
Thrombolytic Therapy - utilization
Time Factors
Tissue Plasminogen Activator - adverse effects
Tissue Plasminogen Activator - therapeutic use
Treatment Outcome
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Summary:Our objective was to identify the outcome of patients treated with tissue plasminogen activator (r-tPa) in Pakistan and compare these data to available regional and international data. The charts of all patients treated with r-tPa for acute stroke at two centers in Pakistan (Aga Khan University, Karachi and Liaquat National hospital, Karachi) were retrospectively reviewed. We identified 21 patients. The utilization of tPa at Aga Khan Hospital was 18/1,185 patients (1.5%) from 2005 to 2007 while at Liaquat National Hospital was 3/575 patients (0.52%) over 1 year (2007). Mean time interval between stroke onset and start of r-tPa infusion was 169 min. Three patients (14%) developed fatal hemorrhage and two (10%) developed non-fatal hemorrhage. Four patients (19%) died. We identified protocol violations in seven patients (33%). In conclusion, the utilization of thrombolytic therapy is low and complication rate is high. Interventions for training physicians are needed.
ISSN:1590-1874
1590-3478
DOI:10.1007/s10072-009-0159-y