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Neurological Sciences

, Volume 39, Issue 3, pp 481–487 | Cite as

Administration of tissue plasminogen activator without coagulation results in a Chinese population

  • Xiaoming Qin
  • Songyao Zhao
  • Liujie Yin
  • Hailing Dou
  • Jie Chen
  • Yifan Wang
  • Mingzhe Li
  • Ruifang Chen
  • Jing Fu
  • Wei Liu
  • Xin Liu
  • Gaiqing Yang
  • Runqing Wang
  • Xinzhou Jia
  • Shufang Bu
  • Dongpu Ma
  • Baoyu Wang
  • Shize LiEmail author
Original Article
  • 142 Downloads

Abstract

Routine coagulation test before intravenous tissue plasminogen activator (tPA) use increases the door to needle time (DNT). We sought to evaluate the safety of tPA use without coagulation results and its impact on prognosis. In our stroke registry, tPA was delivered with coagulation results from December 2015 to April 2016 and without coagulation results from May 2016 to December 2016. Differences of demographics, clinical characteristic, and prognosis between these two groups were analyzed. In addition, logistic regression analysis was conducted to identify predictors for DNT of over 60 min. A total of 201 stroke patients were included in the final analysis. Of these, 81 patients received tPA with coagulation results and 120 patients without coagulation results. Only one (0.8%) patient with abnormal coagulation results met the exclusion criteria of tPA use in patients without coagulation results. The difference of DNT between groups with (mean, 61.7 min) and without (mean, 41.9 min) coagulation results was significant (P = 0.00). The group without coagulation results had a higher rate of favorable 90-day outcome (74.2 vs 70.4%) and lower rates of symptomatic intracranial hemorrhage/nonintracranial hemorrhage (4.9 and 22.2% vs 1.7 and 19.2%) than the group with coagulation results did; these differences were not statistically significant. In multivariate analysis, only tPA use with coagulation results was the predictor for DNT of over 60 min (P = 0.0030, OR = 2.44, 95% CI 1.28–4.65). The present study suggests that tPA could be delivered safely without coagulation results in patients without suspected coagulopathy, and avoiding coagulation tests reduces significantly the DNT interval.

Keywords

Ischemic stroke Thrombolysis Tissue plasminogen activator Coagulopathy Coagulation results DNT 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer-Verlag Italia S.r.l., part of Springer Nature 2018

Authors and Affiliations

  • Xiaoming Qin
    • 1
    • 2
  • Songyao Zhao
    • 1
    • 2
  • Liujie Yin
    • 1
    • 2
  • Hailing Dou
    • 1
    • 2
  • Jie Chen
    • 1
    • 2
  • Yifan Wang
    • 1
    • 2
  • Mingzhe Li
    • 1
    • 2
  • Ruifang Chen
    • 1
    • 2
  • Jing Fu
    • 1
    • 2
  • Wei Liu
    • 1
    • 2
  • Xin Liu
    • 1
    • 2
  • Gaiqing Yang
    • 1
    • 2
  • Runqing Wang
    • 1
    • 2
  • Xinzhou Jia
    • 1
    • 2
  • Shufang Bu
    • 1
    • 2
  • Dongpu Ma
    • 2
    • 3
  • Baoyu Wang
    • 2
    • 3
  • Shize Li
    • 1
    • 2
    Email author
  1. 1.Department of Neurology, Zhengzhou Central HospitalZhengzhou UniversityZhengzhouChina
  2. 2.Stroke Center of Zhengzhou Central HospitalZhengzhou UniversityZhengzhouChina
  3. 3.Emergency Department, Zhengzhou Central HospitalZhengzhou UniversityZhengzhouChina

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