Uzo Dibia

Caboolture Hospital, Australia

BIOGRAPHY

Acute and general physician at the Caboolture hospital, Queensland, and currenlty head of the hospital in the home programme of the Caboolture hospital. Currently pursuing a double masters degree in public health and health management at UNSW.






ABSTRACT

Retrospective observational study of acute stroke thrombolysis at a secondary healthcare centre in Queensland, Australia

Dibia U 1, 2, Saleem J 1, Alchin B 3
1 Department of Internal Medicine, Caboolture Hospital, Caboolture, Queensland, Australia. 4510
2 University of Queensland, St Lucia, Queensland, Australia. 4072
3 Caboolture-Kilcoy Hospitals Innovation and Research Program, Caboolture, Queensland, Australia. 4510.

Background: Achieving a door to needle time of less than 60 minutes may lead to inadvertent thrombolysis of stroke mimics.

Aims/Objectives: To provide descriptive data on stroke thrombolysis patients at Caboolture hospital so as to aid better patient selection for the procedure.

Methods: A retrospective chart review of all patients with acute ischaemic stroke seen between October 1 2013 and June 30 2015 at the Caboolture hospital.

Results: A total of 26 patients (Male 13, Female 13) received stroke thrombolysis. The mean age for all patients was of 76 years.  The average door to needle time was 92minutes (range 30-213 minutes).  24 hour post-thrombolysis computer tomography (CT) imaging confirmed ischaemic stroke in 13(52%) of the thrombolysis patients, whilst 12(48%) did not have ischaemic stroke. Of the 13 confirmed stroke patients, recovery within 24 hours was seen in 4 patients (31%), whilst 9(75%) of the unconfirmed strokes had recovery in the same timeframe. 1(7.7%) patient had symptomatic intracranial haemorrhage in the confirmed stroke group whilst 2(16.7%) in the unconfirmed group had haemorrhage. There were 4 deaths recorded in the confirmed stroke group, whilst only 1 death occurred in those with unproven stroke.

Conclusion: Based on delayed CT imaging, almost half of our patients did not have an ischaemic stroke. Better patient selection prior to thrombolysis and better imaging modalities will prevent potential patient harm and obvious waste of resources.