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10.1111/j.1747-4949.2012.00945.x http://scihub22266oqcxt.onion/10.1111/j.1747-4949.2012.00945.x C3610779!3610779!23227830     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=23227830&cmd=llinks): Failed to open stream: HTTP request failed! 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PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE |pdf=|usr=}}{{23227830}} gab.com Text PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE JO: Int J Stroke http://www.kidney.de/pget.php?&tw=1&pmid=23227830 #FOAvip Objective: To determine factors associated with patients refusing IV t-PA for suspected acute ischemic stroke (AIS), and to compare the outcomes of patients who refused t-PA (RT) with those treated with t-PA. Methods: Patients who were treated with and refused t-PA at our stroke center were identified retrospectively. Demographics, clinical presentation, and outcome measures were collected and compared. Clinical outcome was defined as excellent (mRS: 0?1), good (mRS: 0?2), and poor (mRS: 3?6). Results: Over 7.5 years, thirty (4.2%) patients refused t-PA. There were no demographic differences between the treated and RT groups. The rate of RT decreased over time (OR 0.63, 95% CI 0.50 ? 0.79). Factors associated with refusal included a later symptom onset to emergency department presentation time (OR 1.02, 95% CI 1.01 ? 1.03), lower NIHSS (OR 1.11, 95% CI 1.03 ? 1.18), a higher proportion of stroke mimics (OR 17.61, 95% CI 6.20 ? 50.02) and shorter hospital stay (OR 1.32, 95% CI 1.09 ? 1.61). Among patients who were subsequently diagnosed with ischemic stroke, only length of stay was significantly shorter for refusal patients (OR 1.37, 95% CI 1.06 ? 1.78). After controlling for mild strokes and stroke mimics, clinical outcome was not different between the groups (OR 1.61, 95% CI 0.69 ? 3.73). Conclusion: The incidence of patients refusing t-PA has decreased over time, yet it may be a cause for t-PA under-utilization. Patients with milder symptoms were more likely to refuse t-PA. Refusal patients presented later to the hospital and had shorter hospital stays. One out six refusal patients (16.6%) had a stroke mimic. Twit Text FOAVip PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE ????Int J Stroke http://www.kidney.de/pget.php?&tw=1&pmid=23227830 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=23227830 #FOAvip English Wikipedia <ref>{{Cite pmid|23227830}}</ref> PATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC STROKE #MMPMID23227830 FS V; MH R; AP L; JC G; SI S Int J Stroke 2015[Aug]; 10 (6): 882-6 PMID23227830show ga Objective: To determine factors associated with patients refusing IV t-PA for suspected acute ischemic stroke (AIS), and to compare the outcomes of patients who refused t-PA (RT) with those treated with t-PA. Methods: Patients who were treated with and refused t-PA at our stroke center were identified retrospectively. Demographics, clinical presentation, and outcome measures were collected and compared. Clinical outcome was defined as excellent (mRS: 0?1), good (mRS: 0?2), and poor (mRS: 3?6). Results: Over 7.5 years, thirty (4.2%) patients refused t-PA. There were no demographic differences between the treated and RT groups. The rate of RT decreased over time (OR 0.63, 95% CI 0.50 ? 0.79). Factors associated with refusal included a later symptom onset to emergency department presentation time (OR 1.02, 95% CI 1.01 ? 1.03), lower NIHSS (OR 1.11, 95% CI 1.03 ? 1.18), a higher proportion of stroke mimics (OR 17.61, 95% CI 6.20 ? 50.02) and shorter hospital stay (OR 1.32, 95% CI 1.09 ? 1.61). Among patients who were subsequently diagnosed with ischemic stroke, only length of stay was significantly shorter for refusal patients (OR 1.37, 95% CI 1.06 ? 1.78). After controlling for mild strokes and stroke mimics, clinical outcome was not different between the groups (OR 1.61, 95% CI 0.69 ? 3.73). Conclusion: The incidence of patients refusing t-PA has decreased over time, yet it may be a cause for t-PA under-utilization. Patients with milder symptoms were more likely to refuse t-PA. Refusal patients presented later to the hospital and had shorter hospital stays. One out six refusal patients (16.6%) had a stroke mimic. äPATIENT REFUSAL OF THROMBOLYTIC THERAPY FOR SUSPECTED ACUTE ISCHEMIC S(epmc).pdf DeepDyve Pubget Overpricing