RT Journal Article
SR Electronic
T1 Patterns and outcomes of stroke thrombolysis in a large tertiary care hospital in Riyadh, Saudi Arabia
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 199
OP 206
DO 10.17712/nsj.2021.2.20200171
VO 26
IS 2
A1 Khatri, Ismail A.
A1 AlSkaini, Mohammed
A1 AlDayel, AbdulRahman
A1 Qamra, AlBoqami
A1 Masuadi, Emad
A1 AlShammari, Mufadhi
A1 AlKhalaf, Athal
A1 AlRasheed, Deema
A1 AlKhathaami, Ali
A1 AlOtaibi, Nasir
A1 Tarawneh, Maisoun
A1 AlHizan, Khloud
YR 2021
UL http://nsj.org.sa/content/26/2/199.abstract
AB Objectives: To present the experience on stroke thrombolysis of a tertiary care center in Riyadh, KSA.Methods: Cross-sectional, observational study of patients thrombolyzed between January 2012 and December 2018.Results: Thrombolysis was performed in 148 patients (mean age: 58.2±14.5 years), 94 (63.5%) of them were men. The median onset-to-door time was 81 minutes, and 25% of the patients arrived within 1 hour. The median National Institute of Health Stroke Scale score upon admission was 13. Hypertension (68.9%), diabetes (56.1%), and dyslipidemia (40.5%) were the most common risk factors for stroke. The most common mechanism of stroke was cardioembolism (43.2%), which was associated with a more severe presentation (p=0.031). Intravenous thrombolysis alone was given to 98 patients (66.2%); the rest received intravenous tissue plasminogen activator plus endovascular therapy or endovascular therapy alone. The median door-to-needle (DTN) time was 70.5 min, with a significant improvement from 2012 (111.6 minutes) to 2018 (69.9 minutes) (p<0.001). Among the patients, 53 (35.8%) showed a good outcome (with a modified Rankin score of 0–2) whereas 14 (9.5%) died. Symptomatic intracranial hemorrhage (sICH) was seen in 8.1%. All vascular risk factors were more common in patients aged >60 years, except smoking, which was more common in the younger age group (p=0.007).Conclusion: In our cohort, the utilization of thrombolysis and the DTN time improved over time. One-thirds of the patients received endovascular treatment. Moreover, the frequency of the vascular risk factors was high. Compared with the published findings, our results showed that cardioembolic strokes were the most frequent and had severe presentation and were likely the cause of the slight increase in mortality and sICH.