Abstract
Background and Purpose: To assess the status of intravenous recombinant tissue plasminogen activator (IV t-PA) administration in Japan, we investigated various components in relation to early admission management for acute stroke patients employing a questionnaire sent to hospitals. Methods: From August to October 2007, we sent out questionnaires concerning the infrastructure of acute stroke care to 8569 hospitals. The responses were categorized as follows: 1) stroke service prepared by stroke physicians (SPs) for 24 hr/day, 7 days/week (24/7) ; 2) IV t-PA available 24/7 (t-PA hospital) ; and 3) total number of SPs. The components related to t-PA hospitals were analyzed and the contributions of the number of SPs to the t-PA hospitals were evaluated. Results: Responses were received from 4690 (54.7%) of the 8569 hospitals. Of these, 1466 hospitals (31.3%) were admitting acute stroke patients, and 519 (35.4%) of these 1466 hospitals were t-PA available hospitals. The number of hospitals with fewer than 5 SPs was 326 (63.6%) of the 519 t-PA available hospitals and 861 (93.6%) of the 933 of no t-PA hospitals (p<0.001). Among the t-PA hospitals, 20% had 2 SPs, 50% had 5 SPs, and 90% had more than 10 SPs.
Conclusion: A decreased number of SPs shows an association with IV t-PA availability.
