Is stroke thrombolysis safe and efficacious in Hong Kong?

• Published in: Hong Kong medical journal = Xianggang yi xue za zhi 2012-04, Vol.18 (2), p.92-98
• Main Authors: Wong, Edward H C, Lau, Alexander Y L, Soo, Yannie O Y, Siu, Deyond Y W, Hui, Venus S W, Graham, Colin A, Leung, Thomas W H, Wong, Lawrence K S
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Brain Ischemia - drug therapy; Brain Ischemia - mortality; Cohort Studies; Female; Hong Kong; Humans; Length of Stay; Male; Middle Aged; Stroke; Stroke - drug therapy; Stroke - mortality; Thrombolytic Therapy - adverse effects
• ISSN: 1024-2708; 2226-8707

To investigate the safety and efficacy of stroke thrombolysis in a local hospital. Historical cohort study. A tertiary hospital in Hong Kong. The outcome of acute ischaemic stroke patients treated with intravenous tissue plasminogen activator between October 2008 and May 2011 was compared to those admitted during the same period who were thrombolysis-eligible, but treated conservatively due to unavailability of the thrombolysis service after-hours. Intravenous tissue plasminogen activator. Primary outcome was functional independence (modified Rankin Scale score of 2 or below) at 3 months. Safety outcomes were symptomatic intracranial haemorrhage and 3-month mortality. Secondary outcomes were hospital length of stay, direct home discharge, and nursing home discharge. A total of 48 thrombolysis and 63 non-thrombolysis patients were identified. Fifty-two percent of the thrombolysis group achieved functional independence compared to 24% of non-thrombolysis group (P=0.003), without significant increase in mortality (15% vs 13%, P=0.51) or symptomatic intracranial haemorrhage (4% vs 2%, P=0.58). Twenty-nine percent of the thrombolysis group patients were discharged home directly, versus 6% of non-thrombolysis group (P