Thrombolysis implementation intervention and clinical outcome : a secondary analysis of a cluster randomized trial
U.K., BioMed Central, 2020
Online
academicJournal
Zugriff:
Background: Multiple studies have attempted to increase the rate of intravenous thrombolysis for ischemic stroke using interventions to promote adherence to guidelines. Still, many of them did not measure individual-level impact. This study aimed to make a posthoc comparison of the clinical outcomes of patients in the "Thrombolysis ImPlementation in Stroke (TIPS)"study, which aimed to improve rates of intravenous thrombolysis in Australia. Methods: A posthoc analysis was conducted using individual-level patient data. Excellent (Three-month post treatment modified Rankin Score 0-2) and poor clinical outcome (Three-month post treatment modified Rankin Score 5-6) and post treatment parenchymal haematoma were the three main outcomes, and a mixed logistic regression model was used to assess the difference between the intervention and control groups. Results: There was a non-significant higher odds of having an excellent clinical outcome of 57% (odds ratio: 1.57; 95% CI: 0.73-3.39) and 33% (odds ratio: 1.33; 95% CI: 0.73-2.44) during the active-And post-intervention period respectively, for the intervention compared to the control group. A non-significant lower odds of having a poor clinical outcome was also found in the intervention, relative to control group of 4% (odds ratio: 0.96; 95% CI: 0.56-2.07) and higher odds of having poor outcome of 44% (odds ratio: 1.44 95% CI: 0.61-3.41) during both active and post-intervention period respectively. Similarly, a non-significant lower odds of parenchymal haematoma was also found for the intervention group during the both active-(odds ratio: 0.53; 95% CI: 0.21-1.32) and post-intervention period (odds ratio: 0.96; 95% CI: 0.36-2.52). Conclusion: The TIPS multi-component implementation approach was not effective in reducing the odds of post-Treatment severe disability at 90 days, or post-thrombolysis hemorrhage.
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Thrombolysis implementation intervention and clinical outcome : a secondary analysis of a cluster randomized trial
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Autor/in / Beteiligte Person: | Hasnain, Md Golam ; Paul, Christine L. ; Attia, John R. ; Ryan, Annika ; Kerr, Erin ; Oldmeadow, Christopher ; D'Este, Catherine A. ; Bivard, Andrew ; Hubbard, Isobel J. ; Milton, Abul Hasnat ; Levi, Christopher (R19066) |
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Veröffentlichung: | U.K., BioMed Central, 2020 |
Medientyp: | academicJournal |
DOI: | 10.1186/s12872-020-01705-9 |
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