Intravenous Tissue Plasminogen Activator Can Be Safely Given without Complete Blood Count Results Back

Authors

Yi Dong, Department of Neurology, Huashan Hospital, State Key of Laboratory of Neurobiology, Fudan University at Shanghai, Shanghai, China; INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Lumeng Yang, Department of Neurology, Huashan Hospital, State Key of Laboratory of Neurobiology, Fudan University at Shanghai, Shanghai, China.
Jinma Ren, Center for Outcomes Research, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Deepak S. Nair, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Sarah Parker, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Jan L. Jahnel, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Teresa G. Swanson-Devlin, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Judith M. Beck, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Maureen Mathews, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Clayton J. McNeil, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.
Yifeng Ling, Department of Neurology, Huashan Hospital, State Key of Laboratory of Neurobiology, Fudan University at Shanghai, Shanghai, China.
Xin Cheng, Department of Neurology, Huashan Hospital, State Key of Laboratory of Neurobiology, Fudan University at Shanghai, Shanghai, China.
Yuan Gao, Department of Neurology, The First Affiliated Hospital of Zhengzhou University at Henan, Zhengzhou, China.
Qiang Dong, Department of Neurology, Huashan Hospital, State Key of Laboratory of Neurobiology, Fudan University at Shanghai, Shanghai, China.
David Z. Wang, INI Stroke Network, OSF Healthcare System, Department of Neurology, University of Illinois College of Medicine at Peoria, Peoria, IL, United States of America.Follow

Document Type

Article

Abstract

INTRODUCTION: It is well known that the efficacy of intravenous (i.v.) tissue plasminogen activator (tPA) is time-dependent when used to treat patients with acute ischemic strokes. AIM: Our study examines the safety issue of giving IV tPA without complete blood count (CBC) resulted. MATERIALS AND METHODS: This is a retrospective observational study by examining the database from Huashan Hospital in China and OSF/INI Comprehensive Stroke Center in United States. Patient data collected included demographics, occurrence of symptomatic intracranial hemorrhage, door to needle intervals, National Institute of Health Stroke Scale scores on admission, CBC results on admission and follow-up modified Rankin Scale scores. Linear regression and multivariable logistic regression analysis were used to identify factors that would have an impact on door-to-needle intervals. RESULTS: Our study included 120 patients from Huashan Hospital and 123 patients from INI. Among them, 36 in Huashan Hospital and 51 in INI received i.v. tPA prior to their CBC resulted. Normal platelet count was found in 98.8% patients after tPA was given. One patient had thrombocytopenia but no hemorrhagic event. A significantly shorter door to needle interval (DTN) was found in the group without CBC resulted. There was also a difference in treatment interval between the two hospitals. Door to needle intervals had a strong correlation to onset to treatment intervals and NIHSS scores on admission. CONCLUSION: In patients presented with acute ischemic stroke, the risk of developing hemorrhagic event is low if i.v. tPA is given before CBC has resulted. The door to needle intervals can be significantly reduced.

Medical Subject Headings

Administration, Intravenous (methods); Aged; Blood Cell Count (methods); Blood Cells (drug effects); Blood Platelets (drug effects); Brain Ischemia (drug therapy); China; Female; Humans; Intracranial Hemorrhages (drug therapy); Male; Platelet Count (methods); Retrospective Studies; Risk Factors; Stroke (drug therapy); Thrombolytic Therapy (methods); Time Factors; Tissue Plasminogen Activator (administration & dosage); Treatment Outcome

Publication Date

1-1-2015

Publication Title

PloS one

E-ISSN

1932-6203

Volume

10

Issue

7

First Page

e0131234

PubMed ID

26147994

Digital Object Identifier (DOI)

10.1371/journal.pone.0131234

Recommended Citation

Dong, Yi; Yang, Lumeng; Ren, Jinma; Nair, Deepak S.; Parker, Sarah; Jahnel, Jan L.; Swanson-Devlin, Teresa G.; Beck, Judith M.; Mathews, Maureen; McNeil, Clayton J.; Ling, Yifeng; Cheng, Xin; Gao, Yuan; Dong, Qiang; and Wang, David Z., "Intravenous Tissue Plasminogen Activator Can Be Safely Given without Complete Blood Count Results Back" (2015). Neurology. 1797.
https://scholar.barrowneuro.org/neurology/1797