We use cookies to ensure that we give you the best experience on our website Learn more

Home

Saved research

Submission

EFFECT OF REPORTED CONTRAINDICATIONS FOR INTRAVENOUS THROMBOLYSIS IN PREHOSPITAL SELECTION OF THROMBECTOMY CANDIDATES: SHOULD THEY PLAY A ROLE?

Submitted

12 Views
0 Downloads
0 Saves

Presented at

ESOC-2019

-

Presentation

thumbnail

Abstract

Introduction: The existence of contraindications for intravenous thrombolysis (IVT) has been proposed as criterion for direct transfer to thrombectomy-capable centers (EVT-C) in the prehospital setting. Our aim was to evaluate whether this criterion would improve current patient selection by Madrid-DIRECT prehospital scale. Methods: We carried out a prospective observational study of code stroke patients evaluated by emergency services SUMMA-112 using the Madrid-DIRECT scale from March 2017 to June 2017. We collected reported contraindications for IVT, clinical examination, patient destination according to Madrid-DIRECT score and reperfusion treatments. We analysed the association of IVT contraindications with final diagnosis and treatments. Results: We included 326 patients (mean age 69±15.8 years). 139 (42.6%) patients had a known contraindication for IVT (90 more than 4.5 hours or unknown time from symptom onset, 48 anticoagulation, 17 other contraindications). One hundred patients (30.7%) scored positive in the Madrid-DIRECT scale, and 226 patients (69.3%) scored negative. EVT was performed in 68 (20.9%) patients, 53 (53%) of the Madrid-DIRECT positive and 15 (6.6%) of the Madrid-DIRECT negative. Surprisingly, we found non-significantly lower EVT rates among patients with IVT contraindications: 47.7% vs 57.1% (p = .35) for Madrid-DIRECT positive patients, and 4.2% vs 8.4% (p = .21) for Madrid-DIRECT negative patients. Anticoagulated patients presented with higher proportions of hemorrhagic stroke (25% vs 11.9%) and fewer stroke mimics (4.2% vs 22.7%), p = .02. Conclusions: Existence of IVT contraindications does not increase EVT likelihood over existing Madrid-DIRECT prehospital scale, as it depends on the presence of a treatable large vessel occlusion.

Datasets

No datasets are available for this submission.

License

No license information is available for this submission.

Morressier

Company

Legal

Follow us

© Copyright 2020 Morressier GmbH. All rights reserved.

Morressier

© Copyright 2020 Morressier GmbH.
All rights reserved.