Thrombolysis for Acute XXXX : Outcome and Barriers to Management. Results from the RESUVAL @entity64 Network.

@entity1 @entity64 @entity548 @entity1456 @entity4383 @entity432 @entity1779
BACKGROUND: We evaluated the management, outcome and @entity548 risk in a cohort of @entity64 @entity1 with mild symptoms treated with intravenous @entity1456 (tPA) within the first 4.5 h. METHODS: We analysed data from a prospective @entity64 thrombolysis registry. A total of 1,043 @entity1 received tPA between 2010 and 2014 in the 5 @entity64 units of the RESUVAL @entity64 network (Rh  ne Valley, France). Among them, 170 @entity1 had a National Institute of Health @entity64 Scale (NIHSS) score  <=4 (minor group: MG) before tPA and 873 @entity1 had a NIHSS score >4. RESULTS: A high rate (77%) of excellent outcome (3-month-modified Rankin Scale score  <=1) was observed in the MG. No symptomatic @entity1779 occurred and the rate of any @entity548 @entity4383 was 5%. Fifty-four percent of the MG @entity1 had visible @entity432 before tPA. @entity1 of the MG were less likely to be transported by Emergency Medical Services and to be directly admitted to the @entity64 unit or to imaging. Median delays from onset to admission, from admission to imaging and from onset to tPA were longer in the MG. CONCLUSION: Our data provided evidence of safety and suggested potential benefit of thrombolysis in @entity1 with NIHSS score  <=4. A majority of these @entity1 exhibited @entity432 before thrombolysis. Most often, @entity1 with mild @entity64 are not given priority in terms of the mode of transport, direct admission to @entity64 unit and rapid imaging, resulting in an increased delay from onset to thrombolysis. Health system improvements are needed to provide all suspected @entity64 victims equal access to imaging and treatment on an emergency basis.
