Agreement Among Stroke Faculty and Fellows in Treating Ischemic Stroke Patients With Tissue-Type Plasminogen Activator and Thrombectomy.
Publication/Presentation Date
1-1-2017
Abstract
BACKGROUND AND PURPOSE: The aim of this study is to determine agreement among vascular neurology fellows and faculty in treating patients with acute ischemic stroke with intravenous tissue-type plasminogen activator and intra-arterial thrombectomy (IAT).
METHODS: Patients were evaluated simultaneously by at least 2 vascular neurology. Agreement was determined using kappa (κ) and intraclass correlation coefficients.
RESULTS: In 60 patients, agreement was substantial for tissue-type plasminogen activator (κ=0.75 [95% confidence interval, 0.57-0.92]) and IAT (κ=0.63 [95% confidence interval, 0.30-0.96]), with no difference between fellow-fellow versus fellow-faculty. Intraclass correlation coefficient for National Institutes of Health Stroke Scale was 0.94 (95% confidence interval, 0.90-0.97) and κ for Alberta Stroke Program Early CT Score was 0.53 (95% confidence interval, 0.20-0.78). Rapidly improving or mild deficits caused disagreement for both tissue-type plasminogen activator and IAT, whereas interpretation of computed tomographic perfusion led to disagreement for IAT.
CONCLUSIONS: We found substantial agreement between vascular neurology fellows and faculty in treating with tissue-type plasminogen activator or IAT. Areas for improvement include recognition of stroke mimics, consensus on treating less severe strokes, and use/interpretation of imaging.
Volume
48
Issue
1
First Page
222
Last Page
224
ISSN
1524-4628
Published In/Presented At
Ramadan, A. R., Denny, M. C., Vahidy, F., Yamal, J. M., Wu, T. C., Sarraj, A., Savitz, S., & Grotta, J. (2017). Agreement Among Stroke Faculty and Fellows in Treating Ischemic Stroke Patients With Tissue-Type Plasminogen Activator and Thrombectomy. Stroke, 48(1), 222–224. https://doi.org/10.1161/STROKEAHA.116.015214
Disciplines
Medicine and Health Sciences
PubMedID
27879445
Department(s)
Department of Medicine
Document Type
Article