Shah Aviral, Diwan Arundhati
Department of Medicine, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India.
Department of Medicine, Bharati Vidyapeeth (Deemed to be University) Medical College, Pune, Maharashtra, India.
Indian J Crit Care Med. 2023 Sep;27(9):616-619. doi: 10.5005/jp-journals-10071-24517.
Stroke is a leading cause of morbidity and mortality worldwide. Developing countries, however, still lag behind in providing timely thrombolytic therapy (TLT) to many eligible patients owing to various reasons. This study aims to identify such factors.
This was a descriptive observational study undertaken over a period of 18 months at a tertiary care teaching hospital and included 252 acute ischemic stroke patients of which 200 were not thrombolyzed. The reasons for nonthrombolysis were recorded and analyzed.
The study included 252 acute ischemic stroke patients of which only 20% were thrombolyzed. Of the 200 nonthrombolyzed patients, 55% arrived out of the window period while patient-related factors were the second biggest factor preventing thrombolysis. Hospital factors at 14% and financial constraints at 4.5% contributed significantly. Delayed consent emerged as an important factor making 6% of the delays.
Stroke thrombolysis still faces various pre- and intrahospital barriers in India. There is an urgent need to improve infrastructure and organizational streamlining to enable eligible patients to receive prompt treatment.
Shah A, Diwan A. Stumbling Blocks to Stroke Thrombolysis: An Indian Perspective. Indian J Crit Care Med 2023;27(9):616-619.
中风是全球发病和死亡的主要原因。然而，由于各种原因，发展中国家在为许多符合条件的患者提供及时的溶栓治疗（TLT）方面仍落后。本研究旨在确定这些因素。
这是一项在一家三级护理教学医院进行的为期18个月的描述性观察性研究，纳入了252例急性缺血性中风患者，其中200例未接受溶栓治疗。记录并分析未进行溶栓治疗的原因。
该研究纳入了252例急性缺血性中风患者，其中仅20%接受了溶栓治疗。在200例未接受溶栓治疗的患者中，55%超出了溶栓时间窗，而与患者相关的因素是阻碍溶栓的第二大因素。医院因素占14%，经济限制占4.5%，这些因素的影响显著。延迟同意成为导致6%延误的一个重要因素。
在印度，中风溶栓治疗仍面临各种院前和院内障碍。迫切需要改善基础设施并优化组织流程，以使符合条件的患者能够得到及时治疗。
Shah A, Diwan A. 中风溶栓的绊脚石：印度视角。《印度重症监护医学杂志》2023；27(9):616 - 619。
