Conflict of interest: The authors declare no potential conflict of interest.
Thrombolysis for acute ischemic stroke in South Africa
Article first published online: 22 MAY 2013
© 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization
International Journal of Stroke
Special Issue: World Stroke Day Edition 2013
Volume 8, Issue Supplement A100, pages 112–113, October 2013
How to Cite
Bryer, A. and Wasserman, S. (2013), Thrombolysis for acute ischemic stroke in South Africa. International Journal of Stroke, 8: 112–113. doi: 10.1111/ijs.12059
- Issue published online: 22 OCT 2013
- Article first published online: 22 MAY 2013
- acute stroke therapy;
- developing countries;
- ischemic stroke;
- sub-Saharan Africa;
Stroke is an important cause of death and disability in sub-Saharan Africa. Thrombolysis with recombinant tissue plasminogen activator (tPA) is the only effective therapy for acute ischaemic stroke. Essential requirements for stroke thrombolysis include availability of CT scanning and arrival at hospital within 4.5 hours of symptom onset. However, in developing countries where the prerequisites are met at certain centres, the efficacy and safety of thrombolysis have not been firmly established.
We aimed to evaluate the early outcomes and safety of stroke thrombolysis in a South African setting.
We conducted a prospective observational study of all stroke patients receiving tPA for thrombolysis over the period January 2000 to February 2011. The primary outcome measure was the proportion of patients achieving significant early neurological recovery defined as an improvement of four or more points on the NIHSS score at discharge. The safety endpoint was the rate of symptomatic intracranial haemorrhage (SICH) and death.
Forty-two patients received thrombolysis over the study period. Sixty-seven percent achieved significant neurological improvement. The majority of patients (53.8%) were discharged home, and by the time of discharge 17 (40.5%) were functionally independent. SICH occurred in 2 (4.8%) patients with an overall mortality rate of 7.1%.
Our findings indicate that the use of thrombolysis in routine clinical practice in a South African setting has similar safety and early efficacy outcomes to developed and other developing countries.