5-Years of Thrombolytic Treatment Experience

Year 2023, Cilt 50, Sayı 3, 297 - 303, 15.09.2023

Alpay Tuncar , Hakan Güner Hayri Canbaz , Attila Beştemir

https://doi.org/10.5798/dicletip.1360596

Abstract

Objective: Thrombolytic therapy has a vital role in saving both life and vital functions in emergency room patients. Our aim in our study is to reveal the thrombolytic practice experience of a 3rd level hospital in a long period of 5 years.
Methods: Adult patients who applied to the emergency department between 2017-2022 and were given thrombolytic therapy were selected. Demographic information, risk factors, laboratory and radiological parameters, diagnoses and thrombolytic use of the patients were examined.
Results: 56 patients were included in the study. Survival in patients with comorbidity was lower than in patients without comorbidity (p=0.0036). Survival of patients with a history of cerebrovascular occlusion was lower than those without (p=0.01). There was no statistically significant difference in survival between patients who received coagulation therapy in their history and patients (p>0.05). Survival analysis was performed according to the diagnosis of the patients in the emergency department. There was no statistical significance in terms of survival among patients with different diagnosis types (p=0.098). No statistically significant difference was found in the survival analysis for different application sites of thrombolytic therapy as emergency room, clinical service and intensive care unit (p=0.85). It was observed that doctors started thrombolytic practice as of 2017, and the number of applications increased over the years.
Conclusion: The favorable outcomes thrombolytic therapy have led an increase in the number of thrombolytic therapy conducted by ED clinicians while it was also seen that there was a reduction in morbidity and mortality over time.

Keywords

Emergency department, thrombolytic treatment, comorbidity, mortality.

References

• 1.Rivera-Bou WL, Chersich A. The role of fibrinolytictherapy in the emergency department. Bol Asoc Med PR.2016; 108: 61-4.
• 2.Aguiar de Sousa D, von Martial R, Abilleira S, et al.Access to and delivery of acute ischaemic stroketreatments: A survey of national scientific societies and stroke experts in 44 European countries. Eur Stroke J.2019; 4:13-28.
• 3.Ozturk S. Epidemiology and the global burden ofstroke--situation in Turkey. World Neurosurg. 2014;81: e35-6.
• 4.Şimşek BK, Özer G. Evaluation of stroke mortalityand related risk factors: A single-center cohort studyfrom Gaziantep, Turkey. J Surg Med. 2019; 3(3): 231-4.
• 5.Kutluk K, Kaya D, Afsar N, et al. Analyses of theTurkish National Intravenous Thrombolysis Registry. JStroke Cerebrovasc Dis. 2016; 25: 1041-1047.
• 6.Powers WJ, Rabinstein AA, Ackerson T, et al.American Heart Association Stroke Council. 2018Guidelines for the Early Management of Patients WithAcute Ischemic Stroke: A Guideline for HealthcareProfessionals From the American HeartAssociation/American Stroke Association. Stroke.2018; 49(3): e46-99.
• 7.Topçuoğlu MA, Arsava EM, Özdemir AÖ, et al.Intravenous thrombolytic therapy in acute stroke:Problems and solutions. Turk J Neurol. 2017; 23: 162-75.
• 8.Ibanez B, James S, Agewall S, et al. ESC Guidelines for the management of acute myocardial infarction inpatients presenting with ST-segment elevationTheTask Force for the management of acute myocardialinfarction in patients presenting with ST-segmentelevation of the European Society of Cardiology (ESC).Eur Heart J. 2018; 39: 119-77.
• 9.Karaarslan S, Alihanoglu YI, Yildiz BS, et al.Appropriateness of the current guidelines onreperfusion treatment for patients applying to ourhospital with STsegment elevation acute myocardialinfarction. Turk Kardiyol Dern Ars. 2012; 40: 493-8.
• 10.Beton O, Zorlu A. Fibrinolytic therapy in intensivecare. Turkiye Klinikleri Cardiology-Special Topics.2016; 9: 42-50.
• 11.Güneş M. Relationship between blood pressurelevels during thrombolytic therapy and functionaloutcomes in patients with middle cerebral arteryinfarction. J Surg Med. 2020; 4: 378-82
• 12.Aslaner MA, Baykan N. Experience withthrombolytic therapy in a second-line emergencydepartment. Pamukkale Tıp Dergisi. 2019; 12(2): 309-14.
• 13.Atmaca MM, Kocatürk Ö, Marufoğlu F, et al.Experience of Intravenous Thrombolytic Treatment inSanliurfa: A Prospective Study. Turk Noroloji Dergisi.2019; 25(1): 19.
• 14.Eryıldız ES, Özdemir AÖ. Factors Associated withEarly Complete Recovery After IntravenousThrombolytic Therapy in Acute Ischemic Stroke.Nöropsikiyatri Arşivi. 2018; 55(1): 80-3.
• 15.Tanaka R, Ueno Y, Miyamoto N, et al. Impact ofdiabetes and prediabetes on the short-term prognosisin patients with acute ischemic stroke. J Neurol Sci.2013; 332: 45-50.
• 16.Miedema I, Luijckx GJ, Brouns R, et al. Admissionhyperglycemia and outcome after intravenousthrombolysis: is there a difference among the stroke-subtypes? BMC Neurol. 2016; 16: 104.
• 17.Yilmaz M, Teker H, Yener MO, et al. IntravenousThrombolytic Therapy for Acute Ischemic Stroke:Experiences of a Tertiary Hospital in Turkey. DicleMedical Journal. 2021; 48(1): 55-64.