2010 Volume 32 Issue 4 Pages 365-372
Objectives: The use of thrombolytic therapy with intravenous alteplase (rt-PA therapy) was investigated by prefectures and secondary medical service areas to clarify the current status and regional gaps of medical practice for acute ischemic stroke.
Subjects and methods: We collected all records of rt-PA use during the first 4 years after its approval from the government. Changes in the incidence of rt-PA therapy (the annual number of rt-PA therapy per 100,000 population over 65 years old) were calculated for each secondary medical service area, and the time trends in the use of rt-PA therapy were investigated for each area.
Results: It was estimated that 22,491 patients underwent rt-PA therapy during the 4 years after its approval. Per 100,000 people aged 65 years or older, the number of patients who received rt-PA therapy has increased with time. Of 348 secondary medical service areas, the number of service areas where rt-PA therapy had never been conducted decreased from 61 service areas (18%) in the 2nd year to 44 service areas (13%) in the 4th year. There were regional gaps of the percent use of rt-PA therapy among prefectures and secondary medical service areas.
Conclusions: Government needs to play a central role in taking positive educational activities for stroke and in improving systems for emergency transportation and other relevant measures across barriers among the authorities concerned.
