DOI: 10.36347/sasjm.2016.v02i06.002

Pages: Page: 134-137

The objective of this clinical audit was to report initial experience with the use of intravenous recombinant tissue plasminogen activator (r-tPA) to treat acute ischemic stroke at a tertiary care hospital in Pakistan from the hospital’s prospective stroke registry was taken for analysis. All patients with acute ischemic stroke treated with intravenous r-tPA from January 2015 to February 2016 were included in this audit. Time from stroke onset to arrival at the emergency department (ED), door to needle time, rates of symptomatic intracerebral hemorrhage (ICH), clinical outcomes at 2 and 24 hours as assessed by National Institute of Health Stroke Scale (NIHSS) scores were reported. Among the 312 patients admitted with ischemic stroke, 13 received intravenous r-tPA. Median time from stroke onset to arrival in emergency department was 80 minutes, and median door-to-needle time was 43 minutes. Median times for National Institutes of Health Stroke Scale (NIHSS) recorded at baseline, 2 hours post r-tPA, and 24 hours post r-tPA were 15, 11 and 7 respectively. No patient had symptomatic ICH at 24 hours. No patient received r-tPA 60 minutes after arrival. Rates of favorable outcomes were similar to the ones reported at other specialized centers, and there were no symptomatic ICH at our hospital. However only 13 patients out of a total of 312 were thrombolysed owing to delay in presentation to our facility. Identification and addressing factors and issues related to delay in presentation at a stroke facility equipped with intravenous r-tPA