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Early Presentation Remains Uncommon in Stroke Patients

But intravenous t-PA usage in early arrivals increased significantly between 2001 and 2004

FRIDAY, Oct. 2 (HealthDay News) -- Between 2001 and 2004, there was no change in the proportion of stroke patients who arrived at academic medical centers within two hours of symptom onset. However, usage of intravenous tissue-type plasminogen activator (IV t-PA) in such patients increased, according to a study published online Oct. 1 in Stroke.

Judith H. Lichtman, Ph.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues studied medical records of 428 patients from 2001 and 481 from 2004 who presented at 35 academic medical centers.

The researchers found that a similar proportion of patients in both years arrived within two hours of symptom onset (37 and 38 percent, respectively), but usage of IV t-PA in such patients increased from 14 to 37.5 percent. After risk-adjusted analysis, they found that African-American patients were less likely to arrive within two hours (odds ratio, 0.55) and those with severe strokes were more likely to arrive within two hours (odds ratio, 2.17).

"Longitudinal studies identifying patient and system characteristics associated with presentation delays as part of the development of comprehensive stroke care systems may help target future strategies to increase the number of stroke patients eligible for emergent treatments," the authors conclude.

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