Outcome of intravenous thrombolysis in stroke patients weighing over 100 kg.

Details

Serval ID
serval:BIB_FD0BA1A69CC6
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Outcome of intravenous thrombolysis in stroke patients weighing over 100 kg.
Journal
Cerebrovascular Diseases
Author(s)
Sarikaya H., Arnold M., Engelter S.T., Lyrer P.A., Mattle H.P., Michel P., Odier C., Weder B., Siebel P., Mueller F., Ballinari P., Georgiadis D., Baumgartner R.W.
ISSN
1421-9786 (Electronic)
ISSN-L
1015-9770
Publication state
Published
Issued date
2011
Peer-reviewed
Oui
Volume
32
Number
3
Pages
201-206
Language
english
Abstract
Background: Intravenous thrombolysis with alteplase for ischemic stroke is fixed at a maximal dose of 90 mg for safety reasons. Little is known about the clinical outcomes of stroke patients weighing >100 kg, who may benefit less from thrombolysis due to this dose limitation. Methods: Prospective data on 1,479 consecutive stroke patients treated with intravenous alteplase in six Swiss stroke units were analyzed. Presenting characteristics and the frequency of favorable outcomes, defined as a modified Rankin scale (mRS) score of 0 or 1, a good outcome (mRS score 0-2), mortality and symptomatic intracranial hemorrhage (SICH) were compared between patients weighing >100 kg and those weighing ≤100 kg. Results: Compared to their counterparts (n = 1,384, mean body weight 73 kg), patients weighing >100 kg (n = 95, mean body weight 108 kg) were younger (61 vs. 67 years, p < 0.001), were more frequently males (83 vs. 60%, p < 0.001) and more frequently suffered from diabetes mellitus (30 vs. 13%, p < 0.001). As compared with patients weighing ≤100 kg, patients weighing >100 kg had similar rates of favorable outcomes (45 vs. 48%, p = 0.656), good outcomes (58 vs. 64%, p = 0.270) and mortality (17 vs. 12%, p = 0.196), and SICH risk (1 vs. 5%, p = 0.182). After multivariable adjustment, body weight >100 kg was strongly associated with mortality (p = 0.007) and poor outcome (p = 0.007). Conclusion: Our data do not suggest a reduced likehood of favorable outcomes in patients weighing >100 kg treated with the current dose regimen. The association of body weight >100 kg with mortality and poor outcome, however, demands further large-scale studies to replicate our findings and to explore the underlying mechanisms.
Pubmed
Web of science
Create date
27/10/2011 11:12
Last modification date
20/08/2019 16:28
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