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Gaps and hurdles deter against following stroke guidelines for thrombolytic therapy in Iran: exploring the problem.
- Source :
-
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2015 Feb; Vol. 24 (2), pp. 408-15. Date of Electronic Publication: 2014 Dec 12. - Publication Year :
- 2015
-
Abstract
- Background: Insufficient information is available on the barriers that explain low rates of thrombolytic therapy for acute ischemic stroke (AIS) in developing countries compared with rates in developed societies. By the present study, we aimed to assess the implementation of thrombolytic therapy in the northeast of Iran to explore the gaps and hurdles against thrombolysis as the generally accepted treatment for AIS.<br />Methods: In a 1-year cohort study among AIS patients admitted to the second largest tertiary neurologic referral center in Iran, those who met the prespecified selection criteria were treated with intravenous recombinant tissue plasminogen activator (rtPA).<br />Results: Among 1,144 patients admitted with AIS, only 14 (1.2%) were treated with rtPA. The mean onset-to-needle and door-to-needle times were 172 and 58 minutes, respectively; 980 (85.6%) patients were initially excluded from the study because of late arrival. Additionally, 60 patients in total were omitted because of either their high age (3.7%) or passing the gold standard time limit for rtPA therapy after preliminary evaluations (1.6%), and 90 more patients (7.9%) were considered not suitable for thrombolysis because of the severity of the symptoms or the higher risk of bleeding on rtPA.<br />Conclusions: Access to thrombolytic therapy for AIS in Iran is less than in most developed countries but comparable with other developing countries. Awareness campaigns are needed to minimize barriers and improve access to thrombolysis and specialized stroke care in Iran.<br /> (Copyright © 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Female
Fibrinolytic Agents administration & dosage
Fibrinolytic Agents therapeutic use
Humans
Iran
Male
Middle Aged
Time Factors
Tissue Plasminogen Activator administration & dosage
Tissue Plasminogen Activator therapeutic use
Brain Ischemia drug therapy
Guideline Adherence
Practice Guidelines as Topic
Stroke drug therapy
Thrombolytic Therapy standards
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8511
- Volume :
- 24
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
- Publication Type :
- Academic Journal
- Accession number :
- 25511616
- Full Text :
- https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.09.012