Temporal trends in reperfusion therapy for patients with acute ischemic stroke

El Khoury C, Aboa-Eboule C, Fraticelli L, Claustre C, Bischoff M, Blanc- Lasserre K, Buisson M, Cakmak S, Cho TH, Ferroud-Plattet B, Guerrier O,

Philippeau F, Serre P, Mechtouff L, Nighoghossian N, Ruzteroltz T, Vallet AE, Ong E, Derex L

Journal of the American College of Emergency Physicians Open / February 2022


Objectives: To analyze the temporal trends in thrombolysis rates after implementation of a regional emergency network for acute ischemic stroke (AIS).

Methods: We conducted a retrospective study based on a prospective multicenter observational registry. The AIS benefited from reperfusion therapy included in 1 of the 5 primary stroke units or 1 comprehensive stroke center and 37 emergency departments were included using a standardized case report form. The population covers 3 million inhabitants.

Results: In total, 32,319 AIS was reported in the regional hospitalization database of which 2215 thrombolyzed AIS patients were included in the registry and enrolled in this study. The annual incidence rate of thrombolysis continuously and significantly increased from 2010 to 2018 (10.2% to 17.3%, P-trend = 0.0013). The follow-up of the onset-to-door and the door-to-needle delays over the study period showed stable rates, as did the all-cause mortality rate at 3-months (13.2%).

Conclusion: Although access to stroke thrombolysis has increased linearly since 2010, the 3-month functional outcome has not evolved as favorably. Further efforts must focus on reducing hospital delays.

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