Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study

Thorkild Terkelsen; Marie Louise Schmitz; Claus Z Simonsen; Heidi Holmager Hundborg; Hanne K Christensen; Jesper Gyllenborg; Birgitte F Sandal; Helle K Iversen; Charlotte Madsen; Mary-Jette Rasmussen; Karsten Vestergaard; Grethe Andersen; Søren P Johnsen

doi:10.1177/1747493016654491

Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study

Thorkild Terkelsen, Marie Louise Schmitz, Claus Z Simonsen, Heidi Holmager Hundborg, Hanne K Christensen, Jesper Gyllenborg, Birgitte F Sandal, Helle K Iversen, Charlotte Madsen, Mary-Jette Rasmussen, Karsten Vestergaard, Grethe Andersen, Søren P Johnsen

Department of Clinical Medicine

4 Citations (Scopus)

Abstract

Background

Thrombolysis with intravenous recombinant tissue-type plasminogen activator improves functional outcome in acute ischemic stroke. Few studies have investigated the effects of thrombolysis in a real-world setting. We evaluated the impact of thrombolysis on long-term hospital bed day use and the risk of readmission due to stroke-related complications.

Methods

We conducted a register-based nationwide propensity score-matched follow-up study among ischemic stroke patients in Denmark (2004-2011). Thrombolysed patients were propensity-score matched with non-thrombolysed acute ischemic stroke patients admitted to stroke centers not yet offering thrombolysis in 2004-2006. The outcomes were length of the stroke admission, total all-cause hospital bed day use during the first year after the stroke, and the long-term risk of readmissions. Thrombolysed and non-thrombolysed patients were compared using multivariable log-linear regression and Cox regression.

Results

We identified 1095 thrombolysed and 1095 propensity score matched eligible but non-thrombolysed acute ischemic stroke patients. The median length of the stroke admission was 9 days in the thrombolysed group and 13 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.88; 95% CI: 0.78-1.00). The median all-cause hospital bed day use within the first year was 12 days in the thrombolysed group and 19 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.82; 95% CI: 0.73-0.92). There was no significant difference in the overall risk of readmission (adjusted hazard ratio, 0.91; 95% CI: 0.79-1.04); however, thrombolysis was associated with reduced risk of pneumonia (adjusted hazard ratio, 0.59; 95% CI: 0.35-0.97).

Conclusions

Thrombolysis in ischemic stroke was associated with lower long-term hospital bed day use and decreased risk of readmission due to pneumonia.

Original language	English
Journal	International Journal of Stroke
Volume	11
Issue number	8
Pages (from-to)	910-916
Number of pages	7
ISSN	1747-4930
DOIs	https://doi.org/10.1177/1747493016654491
Publication status	Published - 1 Oct 2016

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Terkelsen, T., Schmitz, M. L., Simonsen, C. Z., Hundborg, H. H., Christensen, H. K., Gyllenborg, J., Sandal, B. F., Iversen, H. K., Madsen, C., Rasmussen, M.-J., Vestergaard, K., Andersen, G., & Johnsen, S. P. (2016). Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study. International Journal of Stroke, 11(8), 910-916. https://doi.org/10.1177/1747493016654491

Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study. / Terkelsen, Thorkild; Schmitz, Marie Louise; Simonsen, Claus Z et al.
In: International Journal of Stroke, Vol. 11, No. 8, 01.10.2016, p. 910-916.

Research output: Contribution to journal › Journal article › Research › peer-review

Terkelsen, T, Schmitz, ML, Simonsen, CZ, Hundborg, HH, Christensen, HK, Gyllenborg, J, Sandal, BF, Iversen, HK, Madsen, C, Rasmussen, M-J, Vestergaard, K, Andersen, G & Johnsen, SP 2016, 'Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study', International Journal of Stroke, vol. 11, no. 8, pp. 910-916. https://doi.org/10.1177/1747493016654491

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title = "Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study",

abstract = "Background Thrombolysis with intravenous recombinant tissue-type plasminogen activator improves functional outcome in acute ischemic stroke. Few studies have investigated the effects of thrombolysis in a real-world setting. We evaluated the impact of thrombolysis on long-term hospital bed day use and the risk of readmission due to stroke-related complications. Methods We conducted a register-based nationwide propensity score-matched follow-up study among ischemic stroke patients in Denmark (2004-2011). Thrombolysed patients were propensity-score matched with non-thrombolysed acute ischemic stroke patients admitted to stroke centers not yet offering thrombolysis in 2004-2006. The outcomes were length of the stroke admission, total all-cause hospital bed day use during the first year after the stroke, and the long-term risk of readmissions. Thrombolysed and non-thrombolysed patients were compared using multivariable log-linear regression and Cox regression. Results We identified 1095 thrombolysed and 1095 propensity score matched eligible but non-thrombolysed acute ischemic stroke patients. The median length of the stroke admission was 9 days in the thrombolysed group and 13 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.88; 95% CI: 0.78-1.00). The median all-cause hospital bed day use within the first year was 12 days in the thrombolysed group and 19 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.82; 95% CI: 0.73-0.92). There was no significant difference in the overall risk of readmission (adjusted hazard ratio, 0.91; 95% CI: 0.79-1.04); however, thrombolysis was associated with reduced risk of pneumonia (adjusted hazard ratio, 0.59; 95% CI: 0.35-0.97). Conclusions Thrombolysis in ischemic stroke was associated with lower long-term hospital bed day use and decreased risk of readmission due to pneumonia.",

author = "Thorkild Terkelsen and Schmitz, {Marie Louise} and Simonsen, {Claus Z} and Hundborg, {Heidi Holmager} and Christensen, {Hanne K} and Jesper Gyllenborg and Sandal, {Birgitte F} and Iversen, {Helle K} and Charlotte Madsen and Mary-Jette Rasmussen and Karsten Vestergaard and Grethe Andersen and Johnsen, {S{\o}ren P}",

year = "2016",

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doi = "10.1177/1747493016654491",

language = "English",

volume = "11",

pages = "910--916",

journal = "International Journal of Stroke",

issn = "1747-4930",

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TY - JOUR

T1 - Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use

T2 - A nationwide propensity score-matched follow-up study

AU - Terkelsen, Thorkild

AU - Schmitz, Marie Louise

AU - Simonsen, Claus Z

AU - Hundborg, Heidi Holmager

AU - Christensen, Hanne K

AU - Gyllenborg, Jesper

AU - Sandal, Birgitte F

AU - Iversen, Helle K

AU - Madsen, Charlotte

AU - Rasmussen, Mary-Jette

AU - Vestergaard, Karsten

AU - Andersen, Grethe

AU - Johnsen, Søren P

PY - 2016/10/1

Y1 - 2016/10/1

N2 - Background Thrombolysis with intravenous recombinant tissue-type plasminogen activator improves functional outcome in acute ischemic stroke. Few studies have investigated the effects of thrombolysis in a real-world setting. We evaluated the impact of thrombolysis on long-term hospital bed day use and the risk of readmission due to stroke-related complications. Methods We conducted a register-based nationwide propensity score-matched follow-up study among ischemic stroke patients in Denmark (2004-2011). Thrombolysed patients were propensity-score matched with non-thrombolysed acute ischemic stroke patients admitted to stroke centers not yet offering thrombolysis in 2004-2006. The outcomes were length of the stroke admission, total all-cause hospital bed day use during the first year after the stroke, and the long-term risk of readmissions. Thrombolysed and non-thrombolysed patients were compared using multivariable log-linear regression and Cox regression. Results We identified 1095 thrombolysed and 1095 propensity score matched eligible but non-thrombolysed acute ischemic stroke patients. The median length of the stroke admission was 9 days in the thrombolysed group and 13 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.88; 95% CI: 0.78-1.00). The median all-cause hospital bed day use within the first year was 12 days in the thrombolysed group and 19 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.82; 95% CI: 0.73-0.92). There was no significant difference in the overall risk of readmission (adjusted hazard ratio, 0.91; 95% CI: 0.79-1.04); however, thrombolysis was associated with reduced risk of pneumonia (adjusted hazard ratio, 0.59; 95% CI: 0.35-0.97). Conclusions Thrombolysis in ischemic stroke was associated with lower long-term hospital bed day use and decreased risk of readmission due to pneumonia.

AB - Background Thrombolysis with intravenous recombinant tissue-type plasminogen activator improves functional outcome in acute ischemic stroke. Few studies have investigated the effects of thrombolysis in a real-world setting. We evaluated the impact of thrombolysis on long-term hospital bed day use and the risk of readmission due to stroke-related complications. Methods We conducted a register-based nationwide propensity score-matched follow-up study among ischemic stroke patients in Denmark (2004-2011). Thrombolysed patients were propensity-score matched with non-thrombolysed acute ischemic stroke patients admitted to stroke centers not yet offering thrombolysis in 2004-2006. The outcomes were length of the stroke admission, total all-cause hospital bed day use during the first year after the stroke, and the long-term risk of readmissions. Thrombolysed and non-thrombolysed patients were compared using multivariable log-linear regression and Cox regression. Results We identified 1095 thrombolysed and 1095 propensity score matched eligible but non-thrombolysed acute ischemic stroke patients. The median length of the stroke admission was 9 days in the thrombolysed group and 13 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.88; 95% CI: 0.78-1.00). The median all-cause hospital bed day use within the first year was 12 days in the thrombolysed group and 19 days in the non-thrombolysed group (adjusted geometric mean ratio, 0.82; 95% CI: 0.73-0.92). There was no significant difference in the overall risk of readmission (adjusted hazard ratio, 0.91; 95% CI: 0.79-1.04); however, thrombolysis was associated with reduced risk of pneumonia (adjusted hazard ratio, 0.59; 95% CI: 0.35-0.97). Conclusions Thrombolysis in ischemic stroke was associated with lower long-term hospital bed day use and decreased risk of readmission due to pneumonia.

U2 - 10.1177/1747493016654491

DO - 10.1177/1747493016654491

M3 - Journal article

C2 - 27312677

SN - 1747-4930

VL - 11

SP - 910

EP - 916

JO - International Journal of Stroke

JF - International Journal of Stroke

IS - 8

ER -

Thrombolysis in acute ischemic stroke is associated with lower long-term hospital bed day use: A nationwide propensity score-matched follow-up study

Abstract

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