Institute of Neurology, School of Medicine, Clinical Centre of Serbia, Dr Subotica 6, Belgrade, Serbia.
Eur Neurol. 2011;66(1):30-6. doi: 10.1159/000328018. Epub 2011 Jun 28.
Worse socioeconomic situation is associated with worse outcomes in stroke cases. Whether it also influences outcomes in patients treated with intravenous thrombolysis remains unknown. The aim of this study was to test the hypothesis that outcomes are less favorable in patients treated with intravenous thrombolysis in Belgrade, Serbia, than in Lille, France.
We compared outcomes at day 7 and month 3, between 123 consecutive stroke patients treated with intravenous thrombolysis in Belgrade and 273 in Lille.
At month 3, there was no significant difference between Belgrade and Lille in patients' excellent outcomes [modified Rankin Scale 0-1; 49.6 vs. 45.4%, odds ratio (OR): 1.21, 95% confidence interval (CI): 0.79-1.86] or in death (11.4 vs. 16.1%, OR 0.67, 95% CI: 0.35-1.27). However, compared with a subgroup of age-matched patients from Lille, Belgrade patients tended to have worse outcomes. Patients from Belgrade were 16 years younger (p < 0.0001), more likely to be men (OR 2.40, 95% CI: 1.52-3.78), and more likely to be smokers (OR 2.24, 95% CI: 1.43-3.51). Also, a trend for a slightly higher rate of symptomatic hemorrhagic transformation was registered in this group (7.3 vs. 3.3%, OR 2.32, 95% CI: 0.90-5.99). In Belgrade, patients arrived 27 min earlier to the hospital (p < 0.0001), but their door-to-needle time was 37 min longer (p < 0.0001). Compared with a subgroup of age-matched patients from Lille, they tended to have worse outcomes.
Intravenous thrombolysis-treated stroke patients in Belgrade have similar outcomes and rates of complications as those from Lille.
较差的社会经济状况与卒中病例的预后较差相关。静脉溶栓治疗的患者预后是否也受其影响尚不清楚。本研究旨在验证一个假设，即与法国里尔相比，塞尔维亚贝尔格莱德接受静脉溶栓治疗的患者预后较差。
我们比较了在贝尔格莱德接受静脉溶栓治疗的 123 例连续卒中患者与在里尔接受治疗的 273 例患者在第 7 天和第 3 个月的结局。
在第 3 个月时，贝尔格莱德和里尔的患者预后良好（改良 Rankin 量表 0-1 分）的比例（49.6% vs. 45.4%，比值比[OR]：1.21，95%置信区间[CI]：0.79-1.86）或死亡率（11.4% vs. 16.1%，OR 0.67，95%CI：0.35-1.27）无显著差异。然而，与里尔的年龄匹配亚组患者相比，贝尔格莱德的患者倾向于预后较差。贝尔格莱德的患者年轻 16 岁（p < 0.0001），男性更多（OR 2.40，95%CI：1.52-3.78），吸烟者更多（OR 2.24，95%CI：1.43-3.51）。此外，该组的症状性出血性转化发生率略高（7.3% vs. 3.3%，OR 2.32，95%CI：0.90-5.99）。在贝尔格莱德，患者到医院的时间早 27 分钟（p < 0.0001），但他们的门到针时间延长了 37 分钟（p < 0.0001）。与里尔的年龄匹配亚组患者相比，他们的预后较差。
与里尔的患者相比，在贝尔格莱德接受静脉溶栓治疗的卒中患者的结局和并发症发生率相似。
