- Title
- Thrombolysis implementation intervention and clinical outcome: a secondary analysis of a cluster randomized trial
- Creator
- Hasnain, Md Golam; Paul, Christine L.; Levi, Christopher R.; Attia, John R.; Ryan, Annika; Kerr, Erin; Oldmeadow, Christopher; D'Este, Catherine A.; Bivard, Andrew; Hubbard, Isobel J.; Milton, Abul Hasnat
- Relation
- NHMRC.569328 http://purl.org/au-research/grants/nhmrc/569328 & 1043913 http://purl.org/au-research/grants/nhmrc/1043913
- Relation
- BMC Cardiovascular Disorders Vol. 20, Issue 1, no. 432
- Publisher Link
- http://dx.doi.org/10.1186/s12872-020-01705-9
- Publisher
- Biomed Central (BMC)
- Resource Type
- journal article
- Date
- 2020
- Description
- Background: Multiple studies have attempted to increase the rate of intravenous thrombolysis for ischemic stroke using interventions to promote adherence to guidelines. Still, many of them did not measure individual-level impact. This study aimed to make a posthoc comparison of the clinical outcomes of patients in the "Thrombolysis ImPlementation in Stroke (TIPS)"study, which aimed to improve rates of intravenous thrombolysis in Australia. Methods: A posthoc analysis was conducted using individual-level patient data. Excellent (Three-month post treatment modified Rankin Score 0-2) and poor clinical outcome (Three-month post treatment modified Rankin Score 5-6) and post treatment parenchymal haematoma were the three main outcomes, and a mixed logistic regression model was used to assess the difference between the intervention and control groups. Results: There was a non-significant higher odds of having an excellent clinical outcome of 57% (odds ratio: 1.57; 95% CI: 0.73-3.39) and 33% (odds ratio: 1.33; 95% CI: 0.73-2.44) during the active-And post-intervention period respectively, for the intervention compared to the control group. A non-significant lower odds of having a poor clinical outcome was also found in the intervention, relative to control group of 4% (odds ratio: 0.96; 95% CI: 0.56-2.07) and higher odds of having poor outcome of 44% (odds ratio: 1.44 95% CI: 0.61-3.41) during both active and post-intervention period respectively. Similarly, a non-significant lower odds of parenchymal haematoma was also found for the intervention group during the both active-(odds ratio: 0.53; 95% CI: 0.21-1.32) and post-intervention period (odds ratio: 0.96; 95% CI: 0.36-2.52). Conclusion: The TIPS multi-component implementation approach was not effective in reducing the odds of post-Treatment severe disability at 90 days, or post-Thrombolysis hemorrhage. Trial registration: Clinical Trial Registration-URL: http://www.anzctr.org.au/ Unique Identifier: ACTRN12613000939796.
- Subject
- ischemic stroke; intravenous thrombolysis; implementation intervention; clinical outcome; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1445867
- Identifier
- uon:42696
- Identifier
- ISSN:1471-2261
- Language
- eng
- Reviewed
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