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Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre

Includes abstract.

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Bibliographic Details
Main Author: Wasserman, Sean
Other Authors: Bryer, Alan
Format: Thesis
Language:English
Published: Department of Medicine 2014
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access_status_str Open Access
author Wasserman, Sean
author2 Bryer, Alan
author_browse Bryer, Alan
Wasserman, Sean
author_facet Bryer, Alan
Wasserman, Sean
author_sort Wasserman, Sean
collection Thesis
description Includes abstract.
format Thesis
id oai:open.uct.ac.za:11427/3493
institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:42:07.673Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2014
publishDateRange 2014
publishDateSort 2014
publisher Department of Medicine
publisherStr Department of Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/3493 Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre Wasserman, Sean Bryer, Alan Internal Medicine Includes abstract. Includes bibliographical references. Stroke is an important cause of death and disability in sub-Saharan Africa. Recombinant tissue plasminogen activator (tPA) thrombolysis is effective in treating acute ischaemic stroke, but may not be a viable option in developing countries. This prospective observational study was designed to assess the short-termoutcomes and safety of tPA for the treatment of stroke at Groote Schuur Hospital.Data was collected from January 2000 to February 2012, and included patients witha clinical diagnosis of acute stroke with onset of stroke symptoms within 4.5 hours ofreceiving thrombolysis. Exclusion criteria were based on the National Institute ofNeurological Disorders and Stroke (NINDS) rt-PA trial protocol (upper age limit was 75 years). Primary outcomes were the proportion of patients achieving significant early neurological recovery defined as an improvement of 4 or more points on the National Institutes of Health stroke scale (NIHSS) score and functional independence defined as a modified Rankin score of 2 or less at discharge. The primary safety measures were the rates of symptomatic intracranial haemorrhage (SICH) and death. From January 2000 to February 2011 42 patients were thrombolysed, with a mean time to tPA infusion of 160 minutes (standard deviation (SD) 50; range 60 - 270). By discharge the median NIHSS score fell from 14 (interquartile range (IQR) 10.5 - 17) to 7.5 (IQR 1 - 15); 28 (66.7%) achieved significant neurological improvement, and 17 (40.5%) were functionally independent. Two patients (4.8%) suffered SICH and there were 3 (7.1%) deaths. Thrombolysis in routine clinical practice in a South African setting has similar safety and early efficacy outcomes to controlled trials and open-label studies in developing and developed countries. 2014-07-29T09:16:43Z 2014-07-29T09:16:43Z 2012 Master Thesis Masters MMed http://hdl.handle.net/11427/3493 eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Internal Medicine
Wasserman, Sean
Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre
thesis_degree_str Master's
title Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre
title_full Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre
title_fullStr Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre
title_full_unstemmed Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre
title_short Early outcomes of thrombolysis for acute ischaemic stroke in a South African tertiary care centre
title_sort early outcomes of thrombolysis for acute ischaemic stroke in a south african tertiary care centre
topic Internal Medicine
url http://hdl.handle.net/11427/3493
work_keys_str_mv AT wassermansean earlyoutcomesofthrombolysisforacuteischaemicstrokeinasouthafricantertiarycarecentre