The rt-PA Treatment in Acute Ischemic Stroke: A National Database Study
Tanpradit E, MD1,2, Vorasoot N, MD1,3, Kasemsap N, MD1,3, Tiamkao S, MD1, Sawanyawisuth K, MD, PhD1,2, Kongbunkiat K, MD1,3
Affiliation : 1 Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand 2 Sleep Apnea Research Group, Research Center in Back, Neck and Other Joint Pain and Human Performance, Research and Training Center for Enhancing Quality of Life of Working Age People, Khon Kaen University, Khon Kaen, Thailand 3 North-Eastern Stroke Research Group, Khon Kaen University, Khon Kaen, Thailand
Objective : To evaluate the treatment outcomes of an intravenous recombinant tissue plasminogen activator (rt-PA) therapy in
acute ischemic stroke from a national database.
Materials and Methods: The present study was a retrospective analytical study. The database used in the present study was a
Universal Health Coverage (UHC) insurance of Thailand. The inclusion criteria were consecutive adult patients diagnosed as acute
ischemic stroke and admitted to the hospital. The study period was between October 1st, 2004 to January 31st, 2013. The authors
compared stroke outcomes, and stroke complications between those who received and did not receive the rt-PA treatment.
Results : During the study period, there were 244,032 patients met the study criteria. Of those, 2,102 patients (0.9%) received the
rt-PA treatment. The rt-PA group had significant better discharge statuses than the no rt-PA group except death (6.9% vs. 6.0%;
p-value = 0.151). There were six significant differences in terms of stroke complications between both groups. The rt-PA group had
higher rates of complication in five items than the no rt-PA group. The no rt-PA group had only significant higher rate of sepsis than
the rt-PA group (3.4% vs. 2.8%; p-value = 0.015).
Conclusion : The rt-PA treatment in acute ischemic stroke patients with the UHC had benefit on discharge status. Some complications
of stroke in the rt-PA treatment were significantly higher than no rt-PA treatment.
Keywords : Functional status, Outcomes, Complications
