Stroke physician vs stroke neurologist - can anyone thrombolyse?
Intern Med J. 2014 Dec 23;
Authors: Lee A, Gaekwad A, Bronca M, Cheruvu L, Davies O, Whitehead C, Agzarian M, Chen C
Abstract
BACKGROUND AND PURPOSE: The aim of this study is to compare the outcomes of thrombolysis under standard clinical settings between subjects treated by a stroke neurologist vs those treated by a non neurologist stroke physician.
METHODS: Single center, observational cohort study of subjects thrombolysed in a calendar year, stratified according to the physician type authorizing thrombolysis. Endpoints measured include proportion of subjects with symptomatic intracranial hemorrhage, door to needle time, change in NIHSS and discharge destination.
RESULTS: Forty-nine subjects with a mean age 76 ± 16 years underwent thrombolysis, 21 were under the care of a stroke neurologist and 28 by a non-neurologist stroke physician. No symptomatic intracranial hemorrhages were observed. There was no difference in terms door to needle time, proportion of individuals with hemorrhagic transformation, mortality or discharge destination between the 2 groups.
CONCLUSION: Due to the single center, observational nature of this study, the equivalent outcomes between those thrombolysed by a stroke neurologist vs those thrombolysed by a stroke physician must be interpreted with caution pending further studies. Nevertheless, in the current setting, no signal for harm has been detected. This study is unique as it is the first to our knowledge comparing outcomes between a neurologist and non-neurologist following thrombolysis.
PMID: 25533873 [PubMed - as supplied by publisher]