Predictors of in-hospital mortality in patients with acute ischemic stroke treated with thrombolytic therapy

Heuschmann PU, Kolominsky-Rabas P, Röther J, Misselwitz B, Lowitzsch K, Heidrich J, Hermanek P, Leffmann C, Sitzer M, Biegler M, Buecker-Nott HJ, Berger K (2004)

Publication Type: Journal article

Publication year: 2004

Journal

Journal of the American Medical Association American Medical Association

Book Volume: 292

Pages Range: 1831-1838

Journal Issue: 15

DOI: 10.1001/jama.292.15.1831

Abstract

Context: Data are limited regarding the risks and benefits of thrombolytic therapy for acute ischemic stroke outside of clinical trials. Objective: To investigate predictors of in-hospital mortality in patients with ischemic stroke treated with intravenous tissue plasminogen activator (tPA) within a pooled analysis of large German stroke registers. Design and Setting: Prospective, observational cohort study conducted at 225 community and academic hospitals throughout Germany cooperating within the German Stroke Registers Study Group. Patients: A total of 1658 patients with acute ischemic stroke who were admitted to study hospitals between 2000 and 2002 and were treated with tPA. Main Outcome Measure: In-hospital mortality. Results: One hundred sixty-six patients (10%) who received tPA died during hospitalization, with 67.5% of these deaths occurring within 7 days. Factors predicting in-hospital death after tPA use were older age (for each 10-year increment in age, adjusted odds ratio [OR], 1.6; 95% confidence interval [CI], 1.3-1.9) and altered level of consciousness (adjusted OR, 3.4; 95% CI, 2.4-4.7). The overall rate of symptomatic intracranial hemorrhage was 7.1% and increased with age. One or more serious complications was observed in 27.2% of all patients and in 83.9% of patients who died after tPA treatment. An inverse relation between the number of patients treated with tPA in the respective hospital and the risk of in-hospital death was observed (adjusted OR, 0.97; 95% CI, 0.96-0.99 for each additional patient treated with tPA per year). Conclusion: In patients with ischemic stroke who are treated with tPA, disturbances of consciousness and increasing age are associated with increased in-hospital mortality.

Authors with CRIS profile

Peter Kolominsky-Rabas Medizinische Fakultät

Involved external institutions

Goethe-Universität Frankfurt am Main DE Germany (DE) Westfälische Wilhelms-Universität (WWU) Münster DE Germany (DE) Institut für Qualitätsentwicklung DE Germany (DE) SQMed GmbH DE Germany (DE) Asklepios Klinik Altona DE Germany (DE)

How to cite

APA:

Heuschmann, P.U., Kolominsky-Rabas, P., Röther, J., Misselwitz, B., Lowitzsch, K., Heidrich, J.,... Berger, K. (2004). Predictors of in-hospital mortality in patients with acute ischemic stroke treated with thrombolytic therapy. Journal of the American Medical Association, 292(15), 1831-1838. https://doi.org/10.1001/jama.292.15.1831

MLA:

Heuschmann, Peter U., et al. "Predictors of in-hospital mortality in patients with acute ischemic stroke treated with thrombolytic therapy." Journal of the American Medical Association 292.15 (2004): 1831-1838.

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