TABLE 1.
Temporal trend in baseline characteristics of patients treated for an acute ischemic stroke with intravenous or intraarterial tPA
| All | October 2010–September 2011 | October 2011–September 2012 | October 2012–September 2013 | October 2013–September 2014 | October 2014–September 2015 | October 2015–September 2016 | October 2016–September 2017 | October 2017–September 2018 | |||
|---|---|---|---|---|---|---|---|---|---|---|---|
| N = 4272 | Missing values | n = 369 | n = 403 | n = 468 | n = 469 | n = 509 | n = 604 | n = 649 | n = 801 | P‐trend | |
| Age, y (median [IQR]) | 74 [63;82] | 2 (0.05%) | 73 [63;80] | 74 [62;81] | 73 [62;81.25] | 75 [62;83] | 75 [64;82] | 73 [64;82] | 73 [62;82] | 74 [62;83] | X0.0643 |
| Age > 80 (%) | 1280 (29.96%) | 2 (0.05%) | 89 (24.12%) | 103 (25.56%) | 131 (27.99%) | 156 (33.26%) | 161 (31.63%) | 177 (29.30%) | 199 (30.66%) | 264 (32.96%) | 0.0013↑ |
| Male sex (%) | 2273 (53.21%) | 15 (0.35%) | 203 (55.01%) | 220 (54.59%) | 271 (57.91%) | 245 (52.24%) | 256 (50.29%) | 325 (53.81%) | 340 (52.39%) | 413 (51.56%) | 0.0823 |
| Male sex and age > 80 (%) | 498 (11.66%) | 4 (0.09%) | 35 (9.49%) | 47 (11.66%) | 52 (11.11%) | 56 (11.94%) | 63 (12.38%) | 75 (12.42%) | 78 (12.02%) | 92 (11.49%) | 0.3927 |
| Female sex and age > 80 (%) | 778 (18.21%) | 6 (0.14%) | 53 (14.36%) | 54 (13.40%) | 78 (16.67%) | 100 (21.32%) | 98 (19.25%) | 102 (16.89%) | 121 (18.64%) | 172 (21.47%) | 0.0009↑ |
| Call to dispatch center (%) | 3543 (82.94%) | 118 (2.76%) | 316 (85.64%) | 347 (86.10%) | 393 (83.97%) | 395 (84.22%) | 434 (85.27%) | 480 (79.47%) | 513 (79.04%) | 665 (83.02%) | 0.0036↓ |
| Transportation | |||||||||||
| ‐ Fire brigade (%) | 2511 (58.78%) | 337 (7.89%) | 136 (36.86%) | 230 (57.07%) | 269 (57.48%) | 300 (63.97%) | 345 (67.78%) | 385 (63.74%) | 403 (62.10%) | 443 (55.31%) | < 0.0001↑ |
| ‐ Ambulance (%) | 433 (10.14%) | 337 (7.89%) | 46 (12.47%) | 58 (14.39%) | 64 (13.68%) | 54 (11.51%) | 42 (8.25%) | 60 (9.93%) | 44 (6.78%) | 65 (8.11%) | < 0.0001↓ |
| ‐ Private vehicle (%) | 248 (5.81%) | 337 (7.89%) | 18 (4.88%) | 20 (4.96%) | 26 (5.56%) | 28 (5.97%) | 26 (5.11%) | 30 (4.97%) | 59 (9.09%) | 41 (5.12%) | 0.1825 |
| ‐ EMS (%) | 482 (11.28%) | 337 (7.89%) | 86 (23.31%) | 55 (13.65%) | 52 (11.11%) | 45 (9.59%) | 47 (9.23%) | 48 (7.95%) | 62 (9.55%) | 87 (10.86%) | < 0.0001↓ |
| In‐hospital transportation (%) | 261 (6.11%) | 337 (7.89%) | 17 (4.61%) | 17 (4.22%) | 24 (5.13%) | 17 (3.62%) | 29 (5.70%) | 44 (7.28%) | 47 (7.24%) | 66 (8.24%) | 0.0001↑ |
| Direct admission to stroke unit (%) | 461 (10.79%) | 172 (4.03%) | 54 (14.63%) | 58 (14.39%) | 63 (13.46%) | 63 (13.43%) | 57 (11.20%) | 61 (10.10%) | 55 (8.47%) | 50 (6.24%) | < 0.0001↓ |
| Direct admission to brain imaging (%) | 2008 (47.00%) | 172 (4.03%) | 211 (57.18%) | 206 (51.12%) | 210 (44.87%) | 199 (42.43%) | 248 (48.72%) | 258 (42.72%) | 274 (42.22%) | 402 (50.19%) | 0.0224↓ |
| Admission to ED (%) | 1546 (36.19%) | 172 (4.03%) | 69 (18.70%) | 129 (32.01%) | 167 (35.68%) | 194 (41.36%) | 188 (36.94%) | 254 (42.05%) | 265 (40.83%) | 280 (34.96%) | < 0.0001↑ |
| Admission to interventional neuroradiology | 67 (1.57%) | 172 (4.03%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 0 (0.00%) | 6 (0.99%) | 26 (4.01%) | 35 (4.37%) | < 0.0001↑ |
| Distance to stroke unit, km (median [IQR]) | 17 [7;32] | 160 (3.75%) | 17 [7;33.5] | 18 [8;34] | 20 [7;35] | 19 [8;32] | 17 [8;33] | 17 [6.625;30] | 18 [7;32] | 16 [5;31] | 0.0228X |
| Distance to stroke unit < 17 km | 1976 (46.25%) | 160 (3.75%) | 172 (46.61%) | 187 (46.40%) | 207 (44.23%) | 199 (42.43%) | 229 (44.99%) | 284 (47.02%) | 301 (46.38%) | 397 (49.56%) | 0.1204 |
| Prestroke disability mRS ≥ 1 (%) | 823 (19.26%) | 137 (3.21%) | 43 (11.65%) | 75 (18.61%) | 103 (22.01%) | 116 (24.73%) | 125 (24.56%) | 104 (17.22%) | 128 (19.72%) | 129 (16.10%) | 0.8196 |
| Prestroke disability mRS ≥ 2 (%) | 459 (10.74%) | 137 (3.21%) | 26 (7.05%) | 43 (10.67%) | 69 (14.74%) | 84 (17.91%) | 69 (13.56%) | 54 (8.94%) | 60 (9.24%) | 54 (6.74%) | 0.0021↓ |
| NIHSS score at admission, (median [IQR]) | 10 [5;17] | 128 (3%) | 11 [6;17] | 11 [6;16] | 10 [6;17] | 8 [5;15] | 10 [5;16] | 9 [5;17] | 9 [5;17] | 9 [4;16] | 0.0001X |
| NIHSS score < 5 (%) | 869 (20.34%) | 128 (3%) | 53 (14.36%) | 65 (16.13%) | 77 (16.45%) | 95 (20.26%) | 108 (21.22%) | 133 (22.02%) | 131 (20.18%) | 207 (25.84%) | < 0.0001↑ |
| NIHSS score > 25 (%) | 60 (1.40%) | 128 (3%) | 8 (2.17%) | 3 (0.74%) | 2 (0.43%) | 5 (1.07%) | 9 (1.77%) | 12 (1.99%) | 12 (1.85%) | 9 (1.12%) | X |
| Wake‐up stroke (%) | 296 (6.93%) | 2666 (62.41%) | 9 (2.44%) | 14 (3.47%) | 30 (6.41%) | 26 (5.54%) | 27 (5.30%) | 42 (6.95%) | 60 (9.24%) | 88 (10.99%) | < 0.0001↑ |
| Blood pressure, mmHg | |||||||||||
| ‐ Systolic (median [IQR]) | 150 [133;165] | 133 (3.11%) | 148.5 [132;164] | 147 [131;163] | 148 [130;162] | 151 [137;168] | 150 [134;165] | 150 [133;166] | 149 [133;164] | 150 [134;169] | 0.0526X |
| ‐ Systolic < 150 mmHg | 2017 (47.21%) | 133 (3.11%) | 187 (50.68%) | 211 (52.36%) | 235 (50.21%) | 201 (42.86%) | 240 (47.15%) | 280 (46.36%) | 318 (49.00%) | 345 (43.07%) | 0.0066↓ |
| ‐ Diastolic (median [IQR]) | 80 [70;90] | 164 (3.84%) | 80 [70;89] | 80 [70;90] | 80 [70;90] | 80 [70;90] | 80 [70;90] | 80 [70;90] | 80 [70;90] | 80 [70;90] | 0.1262X |
| ‐ Diastolic < 80 mmHg | 1854 (43.40%) | 164 (3.84%) | 166 (44.99%) | 191 (47.39%) | 210 (44.87%) | 197 (42.00%) | 224 (44.01%) | 252 (41.72%) | 286 (44.07%) | 328 (40.95%) | 0.0596 |
| ‐ Blood pressure > 180/110 mmHg (%) | 316 (7.40%) | 410 (9.6%) | 24 (6.50%) | 29 (7.20%) | 24 (5.13%) | 37 (7.89%) | 43 (8.45%) | 39 (6.46%) | 53 (8.17%) | 67 (8.36%) | 0.1119 |
| Initial blood glucose mmol/l | 6.5 [5.6;7.8] | 265 (6.2%) | 6.4 [5.55;7.64] | 6.6 [5.8;7.745] | 6.595 [5.5;7.7] | 6.6 [5.6;7.7] | 6.5 [5.61;7.8] | 6.43 [5.6;7.8] | 6.38 [5.5;7.8] | 6.57 [5.6;8.03] | 0.5963X |
| Initial blood glucose < 6.5 mmol/l | 1963 (45.95%) | 265 (6.2%) | 180 (48.78%) | 174 (43.18%) | 203 (43.38%) | 201 (42.86%) | 226 (44.40%) | 293 (48.51%) | 321 (49.46%) | 365 (45.57%) | 0.2690 |
| Prestroke use of oral anticoagulants (median [IQR] | 159 (3.72%) | 427 (10%) | 16 (4.34%) | 19 (4.71%) | 20 (4.27%) | 27 (5.76%) | 26 (5.11%) | 12 (1.99%) | 17 (2.62%) | 22 (2.75%) | 0.0029↓ |
| INR > 1.7 (%) | 21 (0.49%) | 4119 (96.42%) | 6 (1.63%) | 0 (0.00%) | 3 (0.64%) | 4 (0.85%) | 6 (1.18%) | 1 (0.17%) | 1 (0.15%) | 0 (0.00%) | X |
Note: Temporal linear trends were assessed using the Pearson Χ 2 for categorical variables and Mann‐Kendall trend test for continuous variables.
Abbreviations: ED, emergency department; EMS, emergency medical services; INR, international normalized ratio; IQR, interquartile range; mRS, modified Rankin Scale; NIHSS, National Institutes of Health Stroke Scale; tPA, tissue plasminogen activator.