Abstract.
Background: Systemic thrombolysis with tissue plasminogen activator (t-PA) for treatment of acute ischemic stroke was approved in Germany in 2000. Up to now, only data from single centers have been available for the study of the use of thrombolysis in a hospital-based approach outside controlled trials. We therefore sought to determine the frequency of application and complications as well as the patient outcome after t-PA treatment in clinical routine of specialized stroke centers in Germany. Methods: Within the German Stroke Data Bank Collaboration, 6234 consecutive patients with ischemic stroke were prospectively documented in 20 stroke centers between 1998 and 1999. The patients were centrally followed via telephone interview after 3 months and 1 year to assess global functional outcome using the Modified Rankin Scale. Results: 250 patients (4 %) received systemic t-PA treatment during the study period. The baseline characteristics of these patients were comparable to large clinical trials and phase IV studies. Symptomatic and asymptomatic parenchymal hemorrhage occurred in 22 patients (8.8 %) and was fatal in 3 patients. Follow-up data after 3 months were obtained in 82.4 % of all patients, of which 35 % had a favorable functional outcome (mRS ≤ 1), while 23.8 % were severely disabled (mRS ≥ 4) and 17 % had died. Conclusion: The results of our study agree with the assumption that thrombolytic therapy can be performed safely and effectively in daily clinical practice. Nevertheless, the small proportion of patients receiving thrombolysis even in specialized stroke centers calls for further improvement of acute stroke management in Germany.
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Received: 11 February 2002, Received in revised form: 16 October 2002, Accepted: 22 October 2002
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ID="*"Collaborators of the German Stroke Data Bank who contributed data to this study Neurology departments (responsible study investigators): Klinikum Minden (J. Glahn), Krankenhaus München-Harlaching (M. L. J. Wimmer), University of Essen (C. Weimar), University of Homburg (M. P. Roth), University of Leipzig (D. S. Schneider), Benjamin Franklin University of Berlin (H.-C. Koennecke), Asklepiosklinik Salzhausen (G. M. v. Reutern), Rheinische Kliniken Bonn (C. Kley), Klinikum München-Großhadern (G. F. Hamann), University of Heidelberg (P. A. Ringleb), University of Rostock (A. Kloth), St. Katharinen-Hospital Frechen (R. Adams), Klinikum Nürnberg Süd (G. Kroczek), University of Greifswald (J. Machetanz), Charité Berlin (L. Harms), University of Magdeburg (M. Goertler), University of Jena (J. Roether), University of Ulm (M. Riepe), Bürgerhospital Stuttgart (E. Schmid), Krankenanstalten Gilead Bielefeld (A. Schacker).
Correspondence to Roman L. Haberl, M. D.
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Schenkel, J., Weimar, C., Knoll, T. et al. R1 – Systemic thrombolysis in German stroke units . J Neurol 250, 320–324 (2003). https://doi.org/10.1007/s00415-003-1004-5
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DOI: https://doi.org/10.1007/s00415-003-1004-5