Frequency of thrombolytic therapy in @entity1 with acute XXXX and the risk of in-hospital mortality: the German @entity64 Registers Study Group.

@entity1 @entity64 @entity865 @entity4207 @entity204 @entity385
BACKGROUND AND PURPOSE: There is little information about early outcome after intravenous application of tissue-type plasminogen activator ( @entity865 ) for @entity64 @entity1 treated in community-based settings. We investigated the association between @entity865 therapy and in-hospital mortality in a pooled analysis of German @entity64 registers. METHODS: @entity385 @entity1 admitted to hospitals cooperating within the German @entity64 Registers Study Group (ADSR) between January 1, 2000, and December 31, 2000, were analyzed. The ADSR is a network of regional @entity64 registers, combining data from 104 @entity4207 and community hospitals throughout Germany. @entity1 treated with @entity865 were matched to @entity1 not receiving @entity865 on the basis of propensity scores and were analyzed with conditional logistic regression. Analyses were stratified for hospital experience with the administration of @entity865 . RESULTS: A total of 13,440 @entity385 @entity1 were included. Of these, 384 @entity1 (3%) were treated with @entity865 . In-hospital mortality was significantly higher for @entity1 treated with @entity865 compared with @entity1 not receiving @entity865 (11.7% versus 4.5%, respectively; P<0.0001). After matching for propensity score, overall risk of @entity204 was still increased for @entity1 treated with @entity865 (odds ratio [OR], 1.7; 95% CI, 1.0 to 2.8). @entity1 receiving @entity865 in hospitals that administered <or=5 thrombolytic therapies in 2000 had an increased risk of in-hospital mortality (OR, 3.3; 95% CI, 1.1 to 9.9). No significant influence of @entity865 use for risk of @entity204 was found in hospitals administering >5 thrombolytic treatments per year (OR, 1.3; 95% CI, 0.8 to 2.4). CONCLUSIONS: In-hospital mortality of @entity385 @entity1 after @entity865 use varied between hospitals with different experience in @entity865 treatment in routine clinical practice. Our study suggested that thrombolytic therapy in hospitals with limited experience in its application increase the risk of in-hospital mortality.
