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Intravenous thrombo...
Intravenous thrombolysis and platelet count
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Gensicke, H. (author)
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Al Sultan, A. S. (author)
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Strbian, D. (author)
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Hametner, C. (author)
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Zinkstok, S. M. (author)
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Moulin, S. (author)
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Bill, O. (author)
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Zini, A. (author)
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Padjen, V. (author)
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Kagi, G. (author)
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Pezzini, A. (author)
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Seiffge, D. J. (author)
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Traenka, C. (author)
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Raty, S. (author)
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Amiri, H. (author)
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Zonneveld, T. P. (author)
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Lachenmeier, R. (author)
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Polymeris, A. (author)
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Roos, Y. B. (author)
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Gumbinger, C. (author)
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Jovanovic, D. R. (author)
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Curtze, S. (author)
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Sibolt, G. (author)
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Vandelli, L. (author)
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Ringleb, P. A. (author)
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Leys, D. (author)
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Cordonnier, C. (author)
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Michel, P. (author)
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Lyrer, P. A. (author)
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Peters, N. (author)
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- Tatlisumak, Turgut (author)
- Gothenburg University,Göteborgs universitet,Institutionen för neurovetenskap och fysiologi,Institute of Neuroscience and Physiology
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Nederkoorn, P. J. (author)
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Engelter, S. T. (author)
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(creator_code:org_t)
- 2018-01-24
- 2018
- English.
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In: Neurology. - : Ovid Technologies (Wolters Kluwer Health). - 0028-3878 .- 1526-632X. ; 90:8
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
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- ObjectiveTo study the effect of platelet count (PC) on bleeding risk and outcome in stroke patients treated with IV thrombolysis (IVT) and to explore whether withholding IVT in PC < 100 x 10(9)/L is supported.MethodsIn this prospective multicenter, IVT register-based study, we compared PC with symptomatic intracranial hemorrhage (sICH; Second European-Australasian Acute Stroke Study [ECASS II] criteria), poor outcome (modified Rankin Scale score 3-6), and mortality at 3 months. PC was used as a continuous and categorical variable distinguishing thrombocytopenia (<150 x 10(9)/L), thrombocytosis (>450 x 10(9)/L), and normal PC (150-450 x 10(9)/L [reference group]). Moreover, PC < 100 x 10(9)/L was compared to PC 100 x 10(9)/L. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) from the logistic regression models were calculated.ResultsAmong 7,533 IVT-treated stroke patients, 6,830 (90.7%) had normal PC, 595 (7.9%) had thrombocytopenia, and 108 (1.4%) had thrombocytosis. Decreasing PC (every 10 x 10(9)/L) was associated with increasing risk of sICH (ORadjusted 1.03, 95% CI 1.02-1.05) but decreasing risk of poor outcome (ORadjusted 0.99, 95% CI 0.98-0.99) and mortality (ORadjusted 0.98, 95% CI 0.98-0.99). The risk of sICH was higher in patients with thrombocytopenic than in patients with normal PC (ORadjusted 1.73, 95% CI 1.24-2.43). However, the risk of poor outcome (ORadjusted 0.89, 95% CI 0.39-1.97) and mortality (ORadjusted 1.09, 95% CI 0.83-1.44) did not differ significantly. Thrombocytosis was associated with mortality (ORadjusted 2.02, 95% CI 1.21-3.37). Forty-four (0.3%) patients had PC < 100 x 10(9)/L. Their risks of sICH (ORunadjusted 1.56, 95% CI 0.48-5.07), poor outcome (ORadjusted 1.63, 95% CI 0.82-3.24), and mortality (ORadjusted 1.38, 95% CI 0.64-2.98) did not differ significantly from those of patients with PC 100 x 10(9)/L.ConclusionLower PC was associated with increased risk of sICH, while higher PC indicated increased mortality. Our data suggest that PC modifies outcome and complications in individual patients, while withholding IVT in all patients with PC < 100 x 10(9)/L is challenged.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
Keyword
- acute ischemic-stroke
- tissue-plasminogen activator
- health-care
- professionals
- clinical-practice
- iv thrombolysis
- volume
- therapy
- thrombocytopenia
- association
- guidelines
- Neurosciences & Neurology
Publication and Content Type
- ref (subject category)
- art (subject category)
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Neurology
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To the university's database
- By the author/editor
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Gensicke, H.
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Al Sultan, A. S.
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Strbian, D.
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Hametner, C.
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Zinkstok, S. M.
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Moulin, S.
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show more...
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Bill, O.
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Zini, A.
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Padjen, V.
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Kagi, G.
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Pezzini, A.
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Seiffge, D. J.
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Traenka, C.
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Raty, S.
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Amiri, H.
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Zonneveld, T. P.
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Lachenmeier, R.
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Polymeris, A.
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Roos, Y. B.
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Gumbinger, C.
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Jovanovic, D. R.
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Curtze, S.
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Sibolt, G.
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Vandelli, L.
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Ringleb, P. A.
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Leys, D.
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Cordonnier, C.
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Michel, P.
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Lyrer, P. A.
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Peters, N.
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Tatlisumak, Turg ...
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Nederkoorn, P. J ...
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Engelter, S. T.
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Basic Medicine
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and Neurosciences
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Neurology
- Articles in the publication
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Neurology
- By the university
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University of Gothenburg