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Comparative effectiveness of standard care with IV thrombolysis versus without IV thrombolysis for mild ischemic stroke
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نویسنده
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choi j.c. ,jang m.u. ,kang k. ,park j.-m. ,ko y. ,lee s.-j. ,cha j.-k. ,kim d.-h. ,park s.s. ,park t.h. ,lee k.b. ,lee j. ,kim j.-t. ,cho k.-h. ,yu k.-h. ,oh m.-s. ,lee b.-c. ,cho y.-j. ,kim d.-e. ,lee j.s. ,lee j. ,gorelick p.b. ,bae h.-j.
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منبع
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journal of the american heart association - 2015 - دوره : 4 - شماره : 1
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چکیده
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Background: one third of patients presenting with initially mild strokes have unfavorable outcomes,and the efficacy of intravenous thrombolysis (ivt) in this population has not been proven. this study aimed to evaluate the comparative effectiveness of standard care with ivt versus without ivt in mild stroke patients. methods and results-using a multicenter stroke registry database,we identified patients with acute ischemic stroke who presented within 4.5 hours of symptom onset and had initial national institutes of health stroke scale scores ≤5. multivariable logistic analysis and propensity score matching were used to adjust for baseline imbalances between the patients who did and did not receive ivt. adjusted odds ratios and 95% cis of ivt were estimated for 3-month modified rankin scale scores of 0 to 1 and symptomatic. of 13 117 patients with stroke who were hospitalized between april 2008 and may 2012,1386 met the eligibility criteria,and 194 (14.0%) were treated with ivt. for a modified rankin scale of 0 to 1 at 3 months,the adjusted odds ratios were 1.96 (95% ci,1.28 to 3.00; p=0.002) by multivariable logistic analysis and 1.68 (1.10 to 2.56; p=0.02) by propensity score matching analysis,respectively. there was a statistically nonsignificant excess of symptomatic hemorrhagic transformation (odds ratios=3.76 [0.95 to 16.42; p=0.06] and 4.81 [0.84 to 49.34; p=0.09]),respectively. conclusions-in this observational registry-based study,standard care with ivt is more effective than not receiving ivt in mild ischemic stroke patients,and there is a statistically nonsignificant risk of symptomatic hemorrhagic transformation. © 2015 the authors.
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کلیدواژه
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Ischemic stroke; Outcome; Thrombolysis
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آدرس
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department of neurology,jeju national university hospital,jeju, South Korea, department of neurology,seoul national university bundang hospital,seoul national university college of medicine,seongnam, South Korea, department of neurology,eulji general hospital,eulji university,seoul, South Korea, department of neurology,eulji general hospital,eulji university,seoul, South Korea, department of neurology,eulji university hospital,daejeon, South Korea, department of neurology,eulji university hospital,daejeon, South Korea, department of neurology,dong-a university college of medicine,busan, South Korea, department of neurology,dong-a university college of medicine,busan, South Korea, department of neurology,seoul medical center,seoul, South Korea, department of neurology,seoul medical center,seoul, South Korea, department of neurology,soonchunhyang university college of medicine,seoul, South Korea, department of neurology,yeungnam university hospital,daegu, South Korea, department of neurology,chonnam national university hospital,gwangju, South Korea, department of neurology,chonnam national university hospital,gwangju, South Korea, department of neurology,hallym university sacred heart hospital,anyang, South Korea, department of neurology,hallym university sacred heart hospital,anyang, South Korea, department of neurology,hallym university sacred heart hospital,anyang, South Korea, department of neurology,ilsan paik hospital,inje university,goyang, South Korea, department of neurology,dongguk university ilsan hospital,goyang, South Korea, clinical research center,asan medical center,seoul, South Korea, department of biostatistics,korea university college of medicine,seoul, South Korea, department of translational science and molecular medicine,michigan state university college of human medicine,mercy health hauenstein neurosciences,grand rapids,mi, United States, department of neurology,seoul national university bundang hospital,seoul national university college of medicine,seongnam, South Korea
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Authors
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