Time-dependent influence of clinical and demographic characteristics on iv-thrombolysis in the Austrian Stroke Unit Registry Background: Rates of iv-thrombolysis as an established treatment in acute ischemic stroke are increasing over time. We evaluated the influence of clinical and demographic factors on rtPA-treatment over time in an Austrian cohort of stroke-patients. Methods: We analysed data of patients with acute ischemic stroke from 2005-2017 in the Austrian Stroke Unit Registry (ASUR). A time-dependent logistic regression analysis was conducted to describe changes of associations of clinical and demographic factors with rtPA-treatment over time. Results: Overall 96.173 patients were enrolled in the ASUR between 2005 and 2017 of which 16.581 (17.2%) received iv-tPA. We detected lower odds of receiving rtPA-treatment in patients with atrial fibrillation over time (2005-2009: OR=0.93; 2010-2017: OR=0.64, p for interaction of AF and time as independent predictors of rtPA-treatment <0.001). The odds of receiving rtPA-treatment in patients with posterior circulation stroke (PCS) and in patients with an onset-to-door-time (ODT) >180min increased over time (PCS - 2005-2009: OR=0.41, 2010-2017: OR 0.77, p for interaction<0.001; ODT>180min: OR 0.07 vs. OR 0.14, p for interaction=0.004). Age >80years, stroke severity, ODT 120-180min, premorbid mRS and previous stroke were significantly associated with tPA-treatment across both time periods. Conclusion: We observed decreasing odds of rtPA-treatment in patients with AF over the last 7 years. Conversly, in patients with ODT>180min and those with PCS, likelihood of receiving rtPA-treatment increased over the last years.
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