Views on the use of tissue plasminogen activator in acute ischemic stroke: A state-wide survey among neurologists and emergency medicine physicians in Indiana

James F. Meschia, Linda S. Williams, James D. Fleck, Askiel Bruno, José Biller

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Indiana emergency medicine physicians and neurologists were presented with 6 brief cases of patients presenting with acute ischemic stroke and asked whether they would administer tissue plasminogen activator (t-PA) in each case; 25% responded in concordance with published American Heart Association guidelines in all cases. Only 19% gave the appropriate exclusion in the 4 cases with definite exclusion criteria. Administering t-PA to a patient with elevated blood pressure was the most common deviation from the guidelines. More neurologists reported that they would have given t-PA in the exclusion-free scenario (85% v 49%; P<.001). Physicians likely to treat acute stroke patients do not consistently follow published guidelines on the use of intravenous t-PA in acute ischemic stroke. Neurologists were more likely to report that they would use t-PA in an exclusion-free scenario. Continued physician education about thrombolytic use in acute ischemic stroke is needed.

Original languageEnglish (US)
Pages (from-to)207-210
Number of pages4
JournalJournal of Stroke and Cerebrovascular Diseases
Volume8
Issue number4
DOIs
StatePublished - Jul 1 1999
Externally publishedYes

Fingerprint

Emergency Medicine
Tissue Plasminogen Activator
Stroke
Physicians
Guidelines
Neurologists
Surveys and Questionnaires
Blood Pressure
Education

Keywords

  • Acute
  • Cerebral infarction
  • Guidelines
  • Tissue plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Rehabilitation
  • Cardiology and Cardiovascular Medicine

Cite this

Views on the use of tissue plasminogen activator in acute ischemic stroke : A state-wide survey among neurologists and emergency medicine physicians in Indiana. / Meschia, James F.; Williams, Linda S.; Fleck, James D.; Bruno, Askiel; Biller, José.

In: Journal of Stroke and Cerebrovascular Diseases, Vol. 8, No. 4, 01.07.1999, p. 207-210.

Research output: Contribution to journalArticle

@article{9bf9b87c1e9845e18a7826d8a96d3814,
title = "Views on the use of tissue plasminogen activator in acute ischemic stroke: A state-wide survey among neurologists and emergency medicine physicians in Indiana",
abstract = "Indiana emergency medicine physicians and neurologists were presented with 6 brief cases of patients presenting with acute ischemic stroke and asked whether they would administer tissue plasminogen activator (t-PA) in each case; 25{\%} responded in concordance with published American Heart Association guidelines in all cases. Only 19{\%} gave the appropriate exclusion in the 4 cases with definite exclusion criteria. Administering t-PA to a patient with elevated blood pressure was the most common deviation from the guidelines. More neurologists reported that they would have given t-PA in the exclusion-free scenario (85{\%} v 49{\%}; P<.001). Physicians likely to treat acute stroke patients do not consistently follow published guidelines on the use of intravenous t-PA in acute ischemic stroke. Neurologists were more likely to report that they would use t-PA in an exclusion-free scenario. Continued physician education about thrombolytic use in acute ischemic stroke is needed.",
keywords = "Acute, Cerebral infarction, Guidelines, Tissue plasminogen activator",
author = "Meschia, {James F.} and Williams, {Linda S.} and Fleck, {James D.} and Askiel Bruno and Jos{\'e} Biller",
year = "1999",
month = "7",
day = "1",
doi = "10.1016/S1052-3057(99)80068-8",
language = "English (US)",
volume = "8",
pages = "207--210",
journal = "Journal of Stroke and Cerebrovascular Diseases",
issn = "1052-3057",
publisher = "W.B. Saunders Ltd",
number = "4",

}

TY - JOUR

T1 - Views on the use of tissue plasminogen activator in acute ischemic stroke

T2 - A state-wide survey among neurologists and emergency medicine physicians in Indiana

AU - Meschia, James F.

AU - Williams, Linda S.

AU - Fleck, James D.

AU - Bruno, Askiel

AU - Biller, José

PY - 1999/7/1

Y1 - 1999/7/1

N2 - Indiana emergency medicine physicians and neurologists were presented with 6 brief cases of patients presenting with acute ischemic stroke and asked whether they would administer tissue plasminogen activator (t-PA) in each case; 25% responded in concordance with published American Heart Association guidelines in all cases. Only 19% gave the appropriate exclusion in the 4 cases with definite exclusion criteria. Administering t-PA to a patient with elevated blood pressure was the most common deviation from the guidelines. More neurologists reported that they would have given t-PA in the exclusion-free scenario (85% v 49%; P<.001). Physicians likely to treat acute stroke patients do not consistently follow published guidelines on the use of intravenous t-PA in acute ischemic stroke. Neurologists were more likely to report that they would use t-PA in an exclusion-free scenario. Continued physician education about thrombolytic use in acute ischemic stroke is needed.

AB - Indiana emergency medicine physicians and neurologists were presented with 6 brief cases of patients presenting with acute ischemic stroke and asked whether they would administer tissue plasminogen activator (t-PA) in each case; 25% responded in concordance with published American Heart Association guidelines in all cases. Only 19% gave the appropriate exclusion in the 4 cases with definite exclusion criteria. Administering t-PA to a patient with elevated blood pressure was the most common deviation from the guidelines. More neurologists reported that they would have given t-PA in the exclusion-free scenario (85% v 49%; P<.001). Physicians likely to treat acute stroke patients do not consistently follow published guidelines on the use of intravenous t-PA in acute ischemic stroke. Neurologists were more likely to report that they would use t-PA in an exclusion-free scenario. Continued physician education about thrombolytic use in acute ischemic stroke is needed.

KW - Acute

KW - Cerebral infarction

KW - Guidelines

KW - Tissue plasminogen activator

UR - http://www.scopus.com/inward/record.url?scp=0001415503&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0001415503&partnerID=8YFLogxK

U2 - 10.1016/S1052-3057(99)80068-8

DO - 10.1016/S1052-3057(99)80068-8

M3 - Article

C2 - 17895166

AN - SCOPUS:0001415503

VL - 8

SP - 207

EP - 210

JO - Journal of Stroke and Cerebrovascular Diseases

JF - Journal of Stroke and Cerebrovascular Diseases

SN - 1052-3057

IS - 4

ER -