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The Stroke Preclinical Assessment Network Multi-Laboratory Model of Thromboembolic Stroke with Thrombolysis: TE-MCAo
Published on: December 19, 2025
Weight approximation in stroke before thrombolysis: the WAIST-Study: a prospective observational "dose-finding" study
Lorenz Breuer1, Tim Nowe, Hagen B Huttner
1Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, 91054 Erlangen, Germany.
Stroke
|November 13, 2010
Summary
Accurate Alteplase dosing for stroke is critical. Many patients cannot provide their weight, leading to estimation errors and incorrect dosages, impacting patient outcomes. Standardized weighing is recommended.
Area of Science:
- Neurology
- Pharmacology
- Clinical Medicine
Background:
- Accurate weight-based dosing of Alteplase (tissue plasminogen activator [tPA]) is crucial for effective and safe thrombolysis in stroke patients due to its narrow therapeutic range.
- Stroke patients often cannot communicate their body weight (BW), necessitating BW estimation, which can lead to significant dosing errors.
Purpose of the Study:
- To evaluate the availability of BW information for stroke patients undergoing thrombolysis.
- To assess the accuracy of BW estimations by healthcare professionals and patients.
- To determine the frequency and impact of Alteplase dosing errors in a clinical setting.
Main Methods:
- Prospective study of 109 consecutive patients receiving intravenous thrombolysis for stroke.
- Independent BW estimations by physicians, nurses, and technical assistants before therapy.
- Actual patient weighing and anthropometric measurements for BW approximation.
- Assessment of dosing errors and 90-day clinical outcome.
Main Results:
- 50.5% of patients could not provide their BW; relatives were available for only 20% of these cases.
- BW estimation errors ranged from 20.8% (patient) to 42.2% (emergency nurse).
- 29 patients (29%) received Alteplase doses deviating by >10% from the optimal dose (12 underdosed, 17 overdosed).
- Underdosage was an independent predictor of worse outcomes.
Conclusions:
- Reliable BW data are frequently unavailable for stroke patients requiring Alteplase.
- Measuring BW before Alteplase administration is challenging but essential.
- Standardized weighing protocols should be considered to minimize dosing errors and improve patient outcomes in thrombolysis for stroke.
