Type

Journal Article

Authors

J Harbison
P Kelly
D Williams
T Stapleton
E Shelley
I Noone
R Mulcahy
D McCabe
P Marsden
C Macey
and 9 others

Subjects

Psychology

Topics
ireland thrombolytic therapy thrombolysis environment irish safety stroke emergency medicine

Thrombolysis for stroke in Ireland: increasing access and maintaining safety in a challenging environment. (2017)

Abstract In the setting of a national audit of acute stroke services, we examined the delivery of thrombolytic therapy for ischaemic stroke and whether current practice was achieving safe outcomes and consistent delivery for patients. Data obtained from the recent national stroke audit was compared against previous Irish audit, the most recent SSNAP UK stroke audit and the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) study. Thrombolysis was provided in 27 acute hospitals throughout Ireland during the period assessed with 82% (22/27) providing 24/7 access, the remaining sites using redirect policies. Decision to thrombolyse was made by stroke trained consultants in 63% (17/27) of units, with general physicians and emergency medicine consultants covering the other units. Thrombolysis rate for non-haemorrhagic stroke was 11% (n = 80/742, CI 95% ±2.23) versus a 1% rate in the 2008 audit. Sites receiving patients through a redirect policy had the highest thrombolysis rate, an average of 24%. Nearly 30% of cases were thrombolysed on the weekend. Eighty-three percent of cases were managed in a stroke unit at some time during admission versus 54% of the national total cases. Thirty-seven percent of patients were ≥80 years old. The mortality rate was 11.3% versus the national mortality rate for non-thrombolysed ischaemic strokes of 10% (p > 0.5), and this is comparable to the SITS-MOST 2007 study 3-month mortality rate of 11.3% (p > 0.5). Stroke thrombolysis is being effectively and safely provided in acute stroke services in Ireland despite regular involvement of non-specialist staff. There is still potential to improve thrombolysis rate.
Collections Ireland -> Trinity College Dublin -> PubMed

Full list of authors on original publication

J Harbison, P Kelly, D Williams, T Stapleton, E Shelley, I Noone, R Mulcahy, D McCabe, P Marsden, C Macey and 9 others

Experts in our system

1
Joseph A Harbison
Trinity College Dublin
Total Publications: 27
 
2
Peter J Kelly
University College Dublin
Total Publications: 48
 
3
David Williams
Royal College of Surgeons in Ireland
Total Publications: 96
 
4
Tadhg Stapleton
Trinity College Dublin
Total Publications: 5
 
5
Emer Shelley
Royal College of Surgeons in Ireland
Total Publications: 51
 
6
Dominick J H McCabe
Trinity College Dublin
Total Publications: 43