In-hospital ischaemic stroke treated with ...
Document type :
Article dans une revue scientifique: Article original
PMID :
Permalink :
Title :
In-hospital ischaemic stroke treated with intravenous thrombolysis or mechanical thrombectomy
Author(s) :
Caparros, FranÇois [Auteur]
Ferrigno, Marc [Auteur]
Decourcelle, Amelie [Auteur]
Mécanismes de la Tumorigénèse et Thérapies Ciblées (M3T) - UMR 8161
Mécanismes de la Tumorigénèse et Thérapies Ciblées - UMR 8161 [M3T]
Mécanismes de la Tumorigénèse et Thérapies Ciblées - UMR 8161 [M3T]
Hochart, Anais [Auteur]
Moulin, Solene [Auteur]
Dequatre-Ponchelle, Nelly [Auteur]
Bodenant, Marie [Auteur]
Henon, Hilde [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Cordonnier, Charlotte [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
LEYS, Didier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Ferrigno, Marc [Auteur]
Decourcelle, Amelie [Auteur]
Mécanismes de la Tumorigénèse et Thérapies Ciblées (M3T) - UMR 8161
Mécanismes de la Tumorigénèse et Thérapies Ciblées - UMR 8161 [M3T]
Mécanismes de la Tumorigénèse et Thérapies Ciblées - UMR 8161 [M3T]
Hochart, Anais [Auteur]
Moulin, Solene [Auteur]
Dequatre-Ponchelle, Nelly [Auteur]
Bodenant, Marie [Auteur]
Henon, Hilde [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Cordonnier, Charlotte [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
LEYS, Didier [Auteur]
Troubles cognitifs dégénératifs et vasculaires - U1171
Troubles cognitifs dégénératifs et vasculaires - U 1171 - EA 1046 [TCDV]
Journal title :
Journal of Neurology
Abbreviated title :
J. Neurol.
Volume number :
264
Pages :
1804-1810
Publication date :
2017-08-01
ISSN :
0340-5354
English keyword(s) :
In-hospital stroke
Haemorrhagic transformation
Mechanical thrombectomy
Thrombolysis
Cerebral ischaemia
Ischaemic stroke
Haemorrhagic transformation
Mechanical thrombectomy
Thrombolysis
Cerebral ischaemia
Ischaemic stroke
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization ...
Show more >Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3 months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0-1, (2) mRS 0-2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition). Of 1209 patients, 64 (5.3%) had IHS, with an increasing proportion over time (p = 0.001). Their median onset-to-needle time was 128 min vs. 145 in COS (p < 0.001). They were more likely to have had a recent TIA [odds ratio (OR) 30.1; 95% confidence interval (CI) 11.5-78.7], to have been treated by vitamin K antagonist before (OR 4.2; 95% CI 1.4-12.0) and to undergo mechanical thrombectomy (45 vs. 10%, p < 0.001). They were less likely to have a pre-stroke mRS 0-1 (OR 0.22; 95% CI 0.09-0.50). After adjustment, IHS was not associated with any of the four outcome measures. Patients with IHS are treated 17 min earlier than patients with COS, but, taking into account that they were already in the hospital, delays are still too long. Their outcome does not differ from that of patients with COS, suggesting room for improvement if delays can be reduced. IHS being frequent, pre-specified pathways should be organised.Show less >
Show more >Patients with in-hospital strokes (IHS) may be eligible for recanalization therapies. The objective of this study is to compare outcomes in patients with IHS and community-onset strokes (COS) treated by recanalization therapy. We analysed data prospectively collected in consecutive patients treated by thrombolysis, thrombectomy, or both for cerebral ischemia at the Lille University Hospital. We compared four outcomes measures at 3 months in patients with IHS and COS: (1) modified Rankin scale (mRS) 0-1, (2) mRS 0-2, (3) death, and (4) symptomatic intracranial haemorrhage (ECASS 2 definition). Of 1209 patients, 64 (5.3%) had IHS, with an increasing proportion over time (p = 0.001). Their median onset-to-needle time was 128 min vs. 145 in COS (p < 0.001). They were more likely to have had a recent TIA [odds ratio (OR) 30.1; 95% confidence interval (CI) 11.5-78.7], to have been treated by vitamin K antagonist before (OR 4.2; 95% CI 1.4-12.0) and to undergo mechanical thrombectomy (45 vs. 10%, p < 0.001). They were less likely to have a pre-stroke mRS 0-1 (OR 0.22; 95% CI 0.09-0.50). After adjustment, IHS was not associated with any of the four outcome measures. Patients with IHS are treated 17 min earlier than patients with COS, but, taking into account that they were already in the hospital, delays are still too long. Their outcome does not differ from that of patients with COS, suggesting room for improvement if delays can be reduced. IHS being frequent, pre-specified pathways should be organised.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
CNRS
Inserm
Université de Lille
CNRS
Inserm
Université de Lille
Submission date :
2019-11-27T13:35:53Z