کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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1915342 | 1535183 | 2009 | 4 صفحه PDF | دانلود رایگان |
PurposeTo determine the present status of intravenous recombinant tissue plasminogen activator (IV rt-PA) administration in Japan, we investigated the components of stroke case related to IV rt-PA utilization using a questionnaire sent to hospitals.MethodsQuestionnaires about the infrastructure of acute stroke care were sent to 8589 hospitals between August and October 2007. Responses were categorized as follows: 1) stroke service run by stroke physicians (SPs) 24 h/day, 7 days/week (24/7); 2) IV rt-PA utilizable 24/7 (rt-PA hospitals); 3) the total number of SPs. The components related to rt-PA hospitals were analyzed and the significance of the number in SPs to the rt-PA hospital was investigated.ResultsResponses were received from 4690 (54.7%) of 8569 hospitals. Of these, 1466 hospitals were admitting acute stroke patients. 519 of those hospitals were rt-PA hospitals. Of the 1466 (35.4%), 48.4% were serviced 24/7 by SPs, with 75.2% having < 5 SPs. Multivariate analysis revealed administration of rt-PA was significantly associated with > 4 SPs (odds ratios (OR), 2.8; 95% confidence interval (95%CI), 1.9–4.1; p < 0.001). Compared to hospitals with 0–1 SPs as a reference, the OR for rt-PA utilization was 5.6 (95%CI, 2.5–12.9; p < 0.001) with 5 SPs, 10.8 (95%CI, 5.0–23.6; p < 0.001) with 6–10 SPs, and 37.3 (95%CI, 6.5–213.1; p < 0.001) with > 10 SPs.ConclusionsAn increased number of SPs was associated with increased IV rt-PA utilization. Development of stroke centers with larger numbers of SPs is therefore urgently needed.
Journal: Journal of the Neurological Sciences - Volume 279, Issues 1–2, 15 April 2009, Pages 66–69