Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Thrombolysis, Time-to-Treatment and In-Hospital Outcomes Among Young Adults with Ischemic Stroke in China: Findings from a Nationwide Registry Study in China
First author：Haiyan Wang,Hongqiu Gu
Corresponding author：Yong Jiang
essential_information
- Person in charge：Haiyan Wang,Hongqiu Gu
- Data Sources： CSCA
- Number of papers：CSCA20200238
- Published time：2022-06-24
2022-06-24
Published articles
Journal：BMJ open
Publication type: Original Research
IF(IF): 3.006
PMID: 35750455 Link To Pubmed Full text Download
Background And Purpose
To determine whether young adults (< 50 years) with acute ischemic stroke (AIS) are more likely to receive intravenous recombinant tissue plasminogen activator (IV tPA) and have shorter door-to-needle time (DNT).
Method
We analyzed data from the Chinese Stroke Center Alliance (CSCA) registry for AIS patients hospitalized between August 2015 and July 2019. Patients were classified into two groups according to age: young adults (< 50 years of age) and older adults (≥ 50 years of age).
Conclusion
Young adults with AIS were more likely to receive IV tPA than older adults, though there was no difference between the two groups in time to treatment. Compared with older adults, young adults may had better in-hospital outcomes.
Main results
Of 793 175 patients with AIS admitted to 1471 hospitals, 9.1% (71 860) were young adults. Compared to older adults, a higher proportion of young adults received IV tPA among patients without contraindicaitons (7.2% vs. 6.1%, adjusted odds ratio [aOR] 1.13, 95% confidence interval [CI] 1.10-1.17) and among patients without contraindications and with onset-to-door time ≤3.5h (23.6 % vs. 19.3%, aOR 1.20, 95% CI 1.15-1.24). We did not observe differences in onset-to-needle time (median hours 2.7h) or door-to-needle time (DNT) (median minutes 60m) between young and older adults. The proportion of DNT≤30 minutes, DNT≤45 minutes, and DNT≤60 minutes in young and older IV tPA treated patients were 16.9% vs 18.8%, 30.2% vs 32.8% and 50.2% vs 54.2%, respectively. Compared to older adults, young adults treated with IV tPA had lower odds of in-hospital mortality (0.5% vs 1.3%, aOR 0.54, 95% CI 0.35-0.82) and higher odds of independent ambulation at discharge (61.0% vs 53.6%, aOR 1.15, 95% CI 1.08-1.22), and the associations may be partly explained by stroke severity measured by NIHSS score.