Patients with thrombolysed stroke in Vietnam have an excellent outcome: results from the Vietnam Thrombolysis Registry

Eur J Neurol. 2010 Sep;17(9):1188-92. doi: 10.1111/j.1468-1331.2010.02995.x. Epub 2010 Mar 17.

Abstract

Background and purpose: We present the early experience in thrombolysis in three major centers of Ho Chi Minh city, namely 115 People Hospital, Gia Dinh Hospital, and An Binh Hospital.

Methods: A prospective study of consecutive patients treated with intravenous tPA with a treatment protocol similar to that of the National Institute of Neurological Disorders and Stroke (NINDS) trial. National Institutes of Health Stroke Scale (NIHSS) scores on admission and Modified Rankin Scale (MRS) scores at 3 months were measured for all patients. Intracranial and systemic hemorrhagic complications were recorded.

Result: A total of 121 of 6171 (2%) patients with acute IS received thrombolysis over 3 years. Mean age was 57 years (range 18-78) and initial median NIHSS score was 12 (range 5-23). The mean delay between symptom onset and treatment was 143 min (range 50-210). Seventy-three (60.3%) patients received the standard dose with the remaining 48 patients (36.9%) treated with a lower dose, a mean calculated dose of 0.62 mg/kg (range, 0.6-0.86 mg/kg). Over half (56.3%) of the patients receiving low dose achieved functional independence (mRS score 0-1) at 3 months compared with 34.2% in the standard-dose group (P = 0.01). The 3-month mortality rate was also higher in the standard-dose group (2.1% vs. 12.5% with standard-dose tPA; P = 0.04). Symptomatic intracranial hemorrhage was noted in four patients of standard-dose group and one patient of low-dose group (P = 0.36).

Conclusion: Intravenous thrombolysis, particularly in a lower dose, is safe and feasible in the treatment of acute IS in our selected Vietnamese population.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Dose-Response Relationship, Drug
  • Emergency Medical Services / methods
  • Female
  • Fibrinolytic Agents / adverse effects
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Intracranial Thrombosis / drug therapy*
  • Intracranial Thrombosis / mortality
  • Intracranial Thrombosis / prevention & control
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care / methods*
  • Prospective Studies
  • Registries*
  • Stroke / drug therapy*
  • Stroke / mortality
  • Stroke / prevention & control
  • Thrombolytic Therapy / adverse effects
  • Thrombolytic Therapy / methods*
  • Thrombolytic Therapy / statistics & numerical data*
  • Treatment Outcome
  • Vietnam / epidemiology
  • Young Adult

Substances

  • Fibrinolytic Agents