دورية أكاديمية
Intravenous Thrombolysis in Patients Dependent on the Daily Help of Others Before Stroke
| العنوان: | Intravenous Thrombolysis in Patients Dependent on the Daily Help of Others Before Stroke |
|---|---|
| المؤلفون: | Gensicke, Henrik, Strbian, Daniel, Zinkstok, Sanne M., Scheitz, Jan F., Bill, Olivier, Hametner, Christian, Moulin, Solène, Zini, Andrea, Kägi, Georg, Pezzini, Alessandro, Padjen, Visnja, Béjot, Yannick, Corbiere, Sydney, Zonneveld, Thomas P., Seiffge, David J., Roos, Yvo B., Traenka, Christopher, Putaala, Jukka, Peters, Peter, Bonati, Leo H., Curtze, Sami, Erdur, Hebun, Sibolt, Gerli, Koch, Peter, Vandelli, Laura, Ringleb, Peter, Leys, Didier, Cordonnier, Charlotte, Michel, Patrik, Nolte, Christian H., Lyrer, Philippe A., Tatlisumak, Turgut, Nederkoorn, Paul J., Engelter, Stefan T. |
| المساهمون: | Département de neurologie - Department of neurology Hôpital de Bâle, Felix Splatter Hospital Bâle, Hirnschlagzentrum - Stroke center Hôpital de Bâle, Centre d'épidémiologie des populations (CEP), Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc Dijon (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER, Registre Dijonnais des Accidents Vasculaires Cérébraux (AVC) - Dijon Stroke Registry, UNICANCER-UNICANCER-Université de Bourgogne (UB)-Centre Régional de Lutte contre le cancer Georges-François Leclerc Dijon (UNICANCER/CRLCC-CGFL), UNICANCER-UNICANCER-Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Neurologie générale, vasculaire et dégénérative (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Stroke- Hirnschlag -Fund Basel, Swiss National Foundation (Grant number : 33CM30-124119 et 33CM30-140340/1 ), University of Basel |
| المصدر: | ISSN: 0039-2499. |
| بيانات النشر: | HAL CCSD American Heart Association |
| سنة النشر: | 2016 |
| المجموعة: | Université de Bourgogne (UB): HAL |
| مصطلحات موضوعية: | infusions, intravenous, intracranial hemorrhages, outcome assessment (health care), stroke, survivors, acute ischemic-stroke, preexisting disability, controlled-trial, iv thrombolysis, scale, reliability, hemorrhage, statins, risk, [SDV.NEU]Life Sciences [q-bio]/Neurons and Cognition [q-bio.NC] |
| الوصف: | International audience ; Background and Purpose-We compared outcome and complications in patients with stroke treated with intravenous thrombolysis (IVT) who could not live alone without help of another person before stroke (dependent patients) versus independent ones.Methods-In a multicenter IVT-register-based cohort study, we compared previously dependent (prestroke modified Rankin Scale score, 3-5) versus independent (prestroke modified Rankin Scale score, 0-2) patients. Outcome measures were poor 3-month outcome (not reaching at least prestroke modified Rankin Scale [dependent patients]; modified Rankin Scale score of 3-6 [independent patients]), death, and symptomatic intracranial hemorrhage. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (OR [95% confidence interval]) were calculated.Results-Among 7430 IVT-treated patients, 489 (6.6%) were dependent and 6941 (93.4%) were independent. Previous stroke, dementia, heart, and bone diseases were the most common causes of preexisting dependency. Dependent patients were more likely to die (ORunadjusted, 4.55 [3.74-5.53]; ORadjusted, 2.19 [1.70-2.84]). Symptomatic intracranial hemorrhage occurred equally frequent (4.8% versus 4.5%). Poor outcome was more frequent in dependent (60.5%) than in independent (39.6%) patients, but the adjusted ORs were similar (OR adjusted, 0.95 [0.75-1.21]). Among survivors, the proportion of patients with poor outcome did not differ (35.7% versus 31.3%). After adjustment for age and stroke severity, the odds of poor outcome were lower in dependent patients (ORadjusted, 0.64 [0.49-0.84]).Conclusions-IVT-treated stroke patients who were dependent on the daily help of others before stroke carry a higher mortality risk than previously independent patients. The risk of symptomatic intracranial hemorrhage and the likelihood of poor outcome were not independently influenced by previous dependency. Among survivors, poor outcome was avoided at least as effectively in previously dependent patients. Thus, withholding IVT ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | hal-01511888; https://u-bourgogne.hal.science/hal-01511888Test |
| DOI: | 10.1161/STROKEAHA.115.011674 |
| الإتاحة: | https://doi.org/10.1161/STROKEAHA.115.011674Test https://u-bourgogne.hal.science/hal-01511888Test |
| رقم الانضمام: | edsbas.D334FC6D |
| قاعدة البيانات: | BASE |
| DOI: | 10.1161/STROKEAHA.115.011674 |
|---|