Intravenous thrombolysis at a regional referral hospital in the bay area of Osaka city

Abstract

Background and Purpose: Appraisal of the current practice of intravenous thrombolysis with recombinant tissue plasminogen activator (tPA) for treatment of acute ischemic stroke in a large metropolitan city.Method: We analyzed demographic factors, ischemic stroke types, and outcomes of all patients who were treated with tPA between October 11, 2005 and October 10, 2010 in our hospital, which serves as a regional referral center located in the bay area of the metropolitan city of Osaka. We also divided our patients into those residing in the bay area and others residing outside the bay area. For statistical analysis, we used chi-square (Pearson) test or nonparametric Wilcoxon test as indicated. We considered p<0.05 to be significant.Results: The number of cases treated with tPA was 105 (69.2±14.4 years), accounting for 7.0% of all acute ischemic stroke and 0.0088% of local residents. While there were many embolic strokes among those living in the bay area, younger patients and the incidence of cervico-cerebral arterial dissections were encountered among those living outside the bay area.Conclusion: The rate of tPA treatment as per local population was higher than that reported in J-MARS. Regional differences encountered here likely reflected the increase of daytime population by an influx of people to metropolitan cities such as Osaka.