Characteristics of Patients Administrated Thrombolytics in the Emergency Department
Abstract
Objective: Arterial and venous thromboembolism is one of the most prevalent diseases and related to ischemic stroke, pulmonary embolism, and myocardial infarction leading to mortality or morbidity. Fibrinolytic therapy is the most profound lifesaving therapy in these diseases. We aimed to evaluate the demographic features and post- tissue plasminogen activator (tPA) period of patients administered fibrinolytic in the emergency department (ED).
Materials and Methods: This retrospective study was conducted with patients instituted fibrinolytic therapy in the ED between January 2018 and July 2021. Age and gender of the patients, vital signs, laboratory tests, comorbidities, drugs used, lifesaving therapies secondary to the present pathology, tPA complications, mortality and similar presentations within the six months period were recorded to the study form.
Results: A total of 277 patients were included into the study. Ischemic stroke was the most prevalent disease entailing the institution of tPA (n=252; 91%). The study patients mostly used antihypertensives (n=155, 56%), followed by anti-aggregants (n=101, 36.5%). Intracranial hemorrhage (11.9%) was the most frequent complication secondary to tPA and the study patients had mostly undergone thrombectomy as a lifesaving therapy (n=34, 12.4%). The univariate analysis revealed that antiaggregant usage (n=21, 53.8% vs n=80, 33.6%; p=0.01), systolic blood pressure (160 mmHg, IQR: 138-190 vs 150 mmHg 130-169; p=0.02) and diastolic blood pressure (90 mmHg, IQR: 75-100 vs 83 mmHg, IQR: 72-94; p=0.03) differ between the patients with and without a post-tPA hemorrhage.
Conclusion: According to the results of this study, ischemic stroke is the main pathology related to tPA administration in ED. Hypertension was the most seen comorbidity in study patients, mostly using anti-hypertensive and anti-aggregants. Intracranial hemorrhage was the most prevalent complication owing to tPA use, and systolic and diastolic blood pressures and anti-aggregant use pertain to post-tPA hemorrhages.
Keywords
fibrinolytic therapy, stroke, pulmonary embolus, intracranial hemorrhage
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