Thrombolysis Experience in Costa Rica Compared Against Individual Patient Data from two Randomized Controlled Trials

• DOI: 10.1016/j.jstrokecerebrovasdis.2022.106599
• Publication Date: 2022-06-19T08:51:02Z
• Authors: Gabriel Torrealba...; Miguel Barboza-El...; Huberth Fernández...; Muhammad Qasim; Paul Litvak; Travis Rothlisberger; Georgios Tsivgoulis; Andrei V. Alexandrov; Thomas A. Kent; Pitchaiah Mandava
• Keywords: Stroke

We sought to compare thrombolysis outcomes from the Costa Rican Stroke Registry Program (CRSRP) with published individual patient data NINDS and CLOTBUST-ER trials using matching outcome modeling randomized clinical (RCTs).A retrospective observational study subjects on baseline characteristics, CRSRP, control arm of CLOTBUST-ER, interventional trials. Day 7-10/discharge modified Rankin Score (mRS), early mortality was compared between matched subjects. A model derived RCTs developed, were at similar NIHSS scores. CRSRP symptomatic hemorrhage (SICH) rate an Ibero-American cohort (IAC).Of 540 patients, 351 received rt-PA under 3 hours yielding 292 pairs; 161 treated within 4.5 resulting in 151 pairs. The proportion patients achieving excellent (mRS 0-1) did not differ either or (CRSRP vs NINDS: 36.6% 32.9%, p=0.3; CLOTBUST-ER: 26.5% 24.5%, p=0.8). Mortality higher for (7.3% 0.7%, p=0.006), but (6.5% 4.5%, p=0.4). pooled 15 representing 4410 (R2=0.39) showed expected mortality, while lower than mortality. SICH equaled IAC (5.7% 5.7%; p=0.9).Functional thrombolysed favorably datasets, a potential increase