Thrombolysis for stroke in Ireland: increasing access and maintaining safety in a challenging environment
| العنوان: | Thrombolysis for stroke in Ireland: increasing access and maintaining safety in a challenging environment |
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| المؤلفون: | Paul Marsden, Peter J. Kelly, Chris Macey, Rachael Doyle, H. Coetzee, Paul Cotter, David Williams, Joseph Harbison, Dominick J. H. McCabe, Tadhg Stapleton, Cliona Loughnane, Emer Shelley, Paul McElwaine, Carmel Brennan, Joan McCormack, Imelda Noone, Anne Hickey, R. Mulcahy, Frances Horgan |
| المصدر: | Irish Journal of Medical Science (1971 -). 187:275-280 |
| بيانات النشر: | Springer Science and Business Media LLC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, medicine.medical_treatment, Audit, 03 medical and health sciences, Patient safety, 0302 clinical medicine, Fibrinolytic Agents, Ischaemic stroke, medicine, Humans, Thrombolytic Therapy, 030212 general & internal medicine, National audit, Stroke, Aged, business.industry, Mortality rate, General Medicine, Thrombolysis, medicine.disease, Challenging environment, Emergency medicine, Physical therapy, Female, business, Ireland, 030217 neurology & neurosurgery |
| الوصف: | In the setting of a national audit of acute stroke services, we examined the delivery of thrombolytic therapy for ischaemic stroke and whether current practice was achieving safe outcomes and consistent delivery for patients. Data obtained from the recent national stroke audit was compared against previous Irish audit, the most recent SSNAP UK stroke audit and the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) study. Thrombolysis was provided in 27 acute hospitals throughout Ireland during the period assessed with 82% (22/27) providing 24/7 access, the remaining sites using redirect policies. Decision to thrombolyse was made by stroke trained consultants in 63% (17/27) of units, with general physicians and emergency medicine consultants covering the other units. Thrombolysis rate for non-haemorrhagic stroke was 11% (n = 80/742, CI 95% ±2.23) versus a 1% rate in the 2008 audit. Sites receiving patients through a redirect policy had the highest thrombolysis rate, an average of 24%. Nearly 30% of cases were thrombolysed on the weekend. Eighty-three percent of cases were managed in a stroke unit at some time during admission versus 54% of the national total cases. Thirty-seven percent of patients were ≥80 years old. The mortality rate was 11.3% versus the national mortality rate for non-thrombolysed ischaemic strokes of 10% (p > 0.5), and this is comparable to the SITS-MOST 2007 study 3-month mortality rate of 11.3% (p > 0.5). Stroke thrombolysis is being effectively and safely provided in acute stroke services in Ireland despite regular involvement of non-specialist staff. There is still potential to improve thrombolysis rate. |
| تدمد: | 1863-4362 0021-1265 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a5523ce3925f1b88c6e1927187a0753b https://doi.org/10.1007/s11845-017-1661-5 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....a5523ce3925f1b88c6e1927187a0753b |
| قاعدة البيانات: | OpenAIRE |
Find this article in full text from Springer Verlag. | تدمد: | 18634362 00211265 |
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