Stroke patients with mild symptoms might be eligible to receive the clot-busting drug tissue plasminogen activator, but often don’t receive the therapy because they are deemed “too good to treat.”
However, many of these patients don’t fare well after stroke, according to research presented at the American Stroke Association’s International Stroke Conference 2015.
Using the Get With The Guidelines database from Boston’s Massachusetts General Hospital, researchers analyzed 2,745 consecutive stroke admissions between January of 2009 and July of 2013. . Researchers studied which “too-good-to treat”-patients should be considered for tPA because of their risk of poor health or death.
- Of the 238 stroke patients studied who arrived in time to receive tPA but did not receive it because their symptoms were too mild or they were rapidly improving, 89 did not do well and might have benefitted from tPA.
- Only 62 percent of those studied were discharged home. Nearly 27 percent went to inpatient rehabilitation facilities; 8.4 percent to skilled nursing facilities; and more than 2 percent either died or went to hospice.
- Risk factors for having poor outcome post-stroke in this group of patients include: being elderly; having more severe strokes; being Hispanic; and having a stroke that affects both hemispheres of the brain. Hispanics, for example, were 11.43 times more likely than non-Hispanics to suffer with poor health after stroke.
More research is needed to better identify which patients might do poorly without tPA treatment, researchers said.