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Rigshospitalet - a part of Copenhagen University Hospital
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Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study

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  • Thorkild Terkelsen
  • Marie Louise Schmitz
  • Claus Z Simonsen
  • Heidi H Hundborg
  • Hanne K Christensen
  • Jesper Gyllenborg
  • Birgitte F Sandal
  • Helle K Iversen
  • Charlotte Madsen
  • Mary-Jette Rasmussen
  • Karsten Vestergaard
  • Grethe Andersen
  • Søren P Johnsen
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BACKGROUND: Thrombolysis with intravenous recombinant tissue-type plasminogen activator improves functional outcome in acute ischemic stroke. Few studies have investigated the effects of thrombolysis in a real-world setting. We evaluated the impact of thrombolysis on long-term hospital bed day use and the risk of readmission due to stroke-related complications.

METHODS: We conducted a register-based nationwide propensity score-matched follow-up study among ischemic stroke patients in Denmark (2004-2011). Thrombolysed patients were propensity-score matched with non-thrombolysed acute ischemic stroke patients admitted to stroke centers not yet offering thrombolysis in 2004-2006. The outcomes were length of the stroke admission, total all-cause hospital bed day use during the first year after the stroke, and the long-term risk of readmissions. Thrombolysed and non-thrombolysed patients were compared using multivariable log-linear regression and Cox regression.

RESULTS: We identified 1095 thrombolysed and 1095 propensity score matched eligible but non-thrombolysed acute ischemic stroke patients. The median length of the stroke admission was 9 days in the thrombolysed group and 13 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.88; 95% CI: 0.78-1.00). The median all-cause hospital bed day use within the first year was 12 days in the thrombolysed group and 19 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.82; 95% CI: 0.73-0.92). There was no significant difference in the overall risk of readmission (adjusted hazard ratio, 0.91; 95% CI: 0.79-1.04); however, thrombolysis was associated with reduced risk of pneumonia (adjusted hazard ratio, 0.59; 95% CI: 0.35-0.97).

CONCLUSIONS: Thrombolysis in ischemic stroke was associated with lower long-term hospital bed day use and decreased risk of readmission due to pneumonia.

Original languageEnglish
JournalInternational journal of stroke : official journal of the International Stroke Society
Volume11
Issue number8
Pages (from-to)910-16
ISSN1747-4930
DOIs
Publication statusPublished - 16 Jun 2016

ID: 46532110