Influence of neurologists' experience on the outcome of patients treated by intravenous thrombolysis for cerebral ischaemia

Journal of Neurology
Amélie TuffalDidier Leys

Abstract

Intravenous (i.v.) recombinant tissue plasminogen activator (rt-PA) should be available on a 24/7 basis in hospitals admitting patients with stroke. We aimed at evaluating the influence of the number of patients previously treated with i.v. rt-PA by neurologists on patients' outcome. For each patient consecutively treated with i.v. rt-PA for cerebral ischaemia at the Lille University Hospital, we determined the number of previous treatments with rt-PA administered by the neurologist. We performed logistic regression analyses to determine the influence of the experience on the outcome evaluated by the modified Rankin scale (mRS) after 3 months, 0-1 meaning independence, and 0-2 meaning absence of handicap. We compared outcomes of patients treated by the 25% less experienced neurologists with those of trials. Forty-four neurologists treated 800 patients. The experience of the treating neurologist was independently associated with independence (adjusted odds ratio [(adj)OR] 1.062 for 10 patients more; 95% confidence interval [CI] 1.008-1.120), and absence of handicap ((adj)OR 1.076 for 10 patients more; 95%CI 1.016-1.140) at 3 months, but not with symptomatic intracerebral haemorrhage and death. The proportions of patients from th...Continue Reading

References

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Apr 13, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·UNKNOWN Helsinki Stroke Thrombolysis Registry Group

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Citations

Jun 15, 2019·Journal of Neurointerventional Surgery·Ting-Yu LiuYu-Ching Lee

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