Treatment with intravenous thrombolysis in acute ischemic stroke is associated with reduced bed day use: A nationwide propensity score matched follow-up study

Thorkild Terkelsen, Marie Louise Schmitz, Claus Z. Simonsen, Heidi Hundborg, Hanne Christensen, Karsten Ellemann, Karin Geisler, Helle Iversen, Charlotte Madsen, Mary-Jette Rasmussen, Karsten Vestergaard, Grethe Andersen, Søren P. Johnsen

Publikation: Bidrag til tidsskriftKonferenceabstrakt i tidsskriftForskningpeer review

Abstrakt

Introduction: Several studies have demonstrated the beneficial effects of intravenous tissue-type plasminogen activator (IV-tPA) on neurological outcome in acute ischemic stroke. It is uncertain whether the improved neurological outcome also translates into less morbidity and lower need for hospital admissions during follow-up. Methods: We conducted a register-based nationwide propensity score-matched follow-up study among ischemic stroke patients in Denmark (2004-2011). IV-tPA-treated patients were propensity-score matched with IV-tPA eligible but non-treated ischemic stroke patients from stroke centers not offering tPA. The adjusted Hazard ratio (HR) for first readmission was estimated by multivariable Cox regression among patients who survived the initial stroke admission. Total all-cause bed day use in the first year after stroke admission was determined for patients with a potential follow-up time of at least one year and was compared between groups by a paired t-test after logarithmic transformation. Results: We identified 1896 IV-tPA-treated and 1896 corresponding propensity-score matched non-treated patients surviving the initial stroke admission. A total of 43.2% of the patients were readmitted to hospital during a median of 0.8 years. The adjusted HR for first readmission was 0.93 (95% CI: 0.79-1.09) when comparing IV-tPA-treated with non-treated patients. In 1462 matched pairs followed the first year after stroke the median all-cause bed day use was 10 (IQR: 4-37) in the group of tPA-treated and 16 (IQR: 6-43) in the group of non-treated patients. The relative bed day use was 0.81 (95% CI: 0.74-0.88) when comparing IV-tPA-treated with non-treated patients. Conclusion: Use of IV-tPA in ischemic stroke patients was associated with lower long-term all-cause hospital bed day use.
OriginalsprogEngelsk
ArtikelnummerAWMP27
TidsskriftStroke
Vol/bind46
Udgave nummerS1
ISSN0039-2499
StatusUdgivet - 2015
Begivenhed2015 International Stroke Conference - Nashville, USA
Varighed: 11. feb. 201513. feb. 2015

Konference

Konference2015 International Stroke Conference
LandUSA
ByNashville
Periode11/02/201513/02/2015

Emneord

  • *cerebrovascular accident *brain ischemia *propensity score *follow up *American *heart *blood clot lysis *nursing human patient stroke patient hospital readmission proportional hazards model hazard ratio hospital bed Denmark Student t test register hospital admission morbidity hospital tissue plasminogen activator

Citationsformater

Terkelsen, T., Schmitz, M. L., Simonsen, C. Z., Hundborg, H., Christensen, H., Ellemann, K., Geisler, K., Iversen, H., Madsen, C., Rasmussen, M-J., Vestergaard, K., Andersen, G., & Johnsen, S. P. (2015). Treatment with intravenous thrombolysis in acute ischemic stroke is associated with reduced bed day use: A nationwide propensity score matched follow-up study. Stroke, 46(S1), [AWMP27 ].