| Intravenous thrombolytic treatment compared to standard medical care for wake‐up stroke |
|
Patient or population: people with stroke upon awakening
Setting: hospital emergency department
Intervention: intravenous thrombolytic treatment
Comparison: standard medical care |
| Outcomes |
Anticipated absolute effects* (95% CI) |
Relative effect
(95% CI) |
No. of participants
(studies) |
Certainty of the evidence
(GRADE) |
| Risk with standard medical care |
Risk with intravenous thrombolytic treatment |
| Independent functional outcome at end of follow‐up assessed with: mRS 0 to 2 at follow‐up: 90 days |
584 per 1000 |
660 per 1000
(590 to 736) |
RR 1.13
(1.01 to 1.26) |
763
(5 RCTs) |
⊕⊕⊕⊕
HIGH |
| Symptomatic intracranial haemorrhage at follow‐up: mean 90 days |
5 per 1000 |
19 per 1000
(5 to 67) |
RR 3.47
(0.98 to 12.26) |
754
(4 RCTs) |
⊕⊕⊕⊕
HIGH |
| Death at follow‐up: mean 90 days |
99 per 1000 |
67 per 1000
(43 to 106) |
RR 0.68
(0.43 to 1.07) |
763
(5 RCTs) |
⊕⊕⊕⊕
HIGH |
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval;mRS: modified Rankin Scale; RCT: randomised controlled trial; RR: risk ratio |
|
GRADE Working Group grades of evidence
High certainty: We are very confident that the true effect lies close to that of the estimate of the effect
Moderate certainty: We are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect.
Very low certainty: We have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. |
