Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country

Abstract Background Stroke related deaths are relatively higher in low- and middle-income countries where only a fraction of eligible patients undergo thrombolysis. There is also limited evidence on post-thrombolysis outcomes of patients from Asian countries in these income bands. Methods This is a...

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Autores principales:	H. M. M. T. B. Herath, Chaturaka Rodrigo, A. M. B. D. Alahakoon, Sathyajith Buddhika Ambawatte, Sunethra Senanayake, Bimsara Senanayake, Arjuna Fernando
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Stroke Thrombolysis Sri Lanka Observational prospective study Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/b1289c10e8ef4d2bb5c14a26c8e81625
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spelling	oai:doaj.org-article:b1289c10e8ef4d2bb5c14a26c8e816252021-11-14T12:13:23ZOutcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country10.1186/s12883-021-02475-31471-2377https://doaj.org/article/b1289c10e8ef4d2bb5c14a26c8e816252021-11-01T00:00:00Zhttps://doi.org/10.1186/s12883-021-02475-3https://doaj.org/toc/1471-2377Abstract Background Stroke related deaths are relatively higher in low- and middle-income countries where only a fraction of eligible patients undergo thrombolysis. There is also limited evidence on post-thrombolysis outcomes of patients from Asian countries in these income bands. Methods This is a single center prospective observational study of a patient cohort with acute ischaemic stroke, undergoing thrombolysis with alteplase (low and standard dose), over a 24-month period in 2019/2020. Modified Rankin scale (mRS) for dependency at 3 months (primary outcome), duration of hospital stay, incidence of symptomatic intracranial haemorrhages and all-cause mortality at 3 months (secondary outcomes) were recorded. Demographic, clinical and treatment related factors associated with these outcomes were explored. Results Eighty-nine patients (males – 61, 69%, mean age: 60 years ±12.18) were recruited. Time from symptom onset to reperfusion was 174 min ± 56.50. Fifty-one patients were independent according to mRS, 11 (12.4%) patients died, and 11 (12.5%) developed symptomatic intracranial haemorrhages by 3 months. Functional independence at 3 months was independently associated with National Institutes of Health Stroke Scale (NIHSS) on admission (p < 0.05). Thrombolysis with low dose alteplase did not lead to better or worse outcomes compared to standard dose. Conclusions On admission NIHSS is predictive of functional independence at 3 months post-thrombolysis. Low dose alteplase may be as efficacious as standard dose alteplase with associated cost savings, but this needs to be confirmed by a prospective clinical trial for the Sri Lankan population.H. M. M. T. B. HerathChaturaka RodrigoA. M. B. D. AlahakoonSathyajith Buddhika AmbawatteSunethra SenanayakeBimsara SenanayakeArjuna FernandoBMCarticleStrokeThrombolysisSri LankaObservational prospective studyNeurology. Diseases of the nervous systemRC346-429ENBMC Neurology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Stroke Thrombolysis Sri Lanka Observational prospective study Neurology. Diseases of the nervous system RC346-429
spellingShingle	Stroke Thrombolysis Sri Lanka Observational prospective study Neurology. Diseases of the nervous system RC346-429 H. M. M. T. B. Herath Chaturaka Rodrigo A. M. B. D. Alahakoon Sathyajith Buddhika Ambawatte Sunethra Senanayake Bimsara Senanayake Arjuna Fernando Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
description	Abstract Background Stroke related deaths are relatively higher in low- and middle-income countries where only a fraction of eligible patients undergo thrombolysis. There is also limited evidence on post-thrombolysis outcomes of patients from Asian countries in these income bands. Methods This is a single center prospective observational study of a patient cohort with acute ischaemic stroke, undergoing thrombolysis with alteplase (low and standard dose), over a 24-month period in 2019/2020. Modified Rankin scale (mRS) for dependency at 3 months (primary outcome), duration of hospital stay, incidence of symptomatic intracranial haemorrhages and all-cause mortality at 3 months (secondary outcomes) were recorded. Demographic, clinical and treatment related factors associated with these outcomes were explored. Results Eighty-nine patients (males – 61, 69%, mean age: 60 years ±12.18) were recruited. Time from symptom onset to reperfusion was 174 min ± 56.50. Fifty-one patients were independent according to mRS, 11 (12.4%) patients died, and 11 (12.5%) developed symptomatic intracranial haemorrhages by 3 months. Functional independence at 3 months was independently associated with National Institutes of Health Stroke Scale (NIHSS) on admission (p < 0.05). Thrombolysis with low dose alteplase did not lead to better or worse outcomes compared to standard dose. Conclusions On admission NIHSS is predictive of functional independence at 3 months post-thrombolysis. Low dose alteplase may be as efficacious as standard dose alteplase with associated cost savings, but this needs to be confirmed by a prospective clinical trial for the Sri Lankan population.
format	article
author	H. M. M. T. B. Herath Chaturaka Rodrigo A. M. B. D. Alahakoon Sathyajith Buddhika Ambawatte Sunethra Senanayake Bimsara Senanayake Arjuna Fernando
author_facet	H. M. M. T. B. Herath Chaturaka Rodrigo A. M. B. D. Alahakoon Sathyajith Buddhika Ambawatte Sunethra Senanayake Bimsara Senanayake Arjuna Fernando
author_sort	H. M. M. T. B. Herath
title	Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
title_short	Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
title_full	Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
title_fullStr	Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
title_full_unstemmed	Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country
title_sort	outcomes of stroke patients undergoing thrombolysis in sri lanka; an observational prospective study from a low-middle income country
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b1289c10e8ef4d2bb5c14a26c8e81625
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Outcomes of stroke patients undergoing thrombolysis in Sri Lanka; an observational prospective study from a low-middle income country

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