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A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model
Published on: June 4, 2021
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Do All Acute Stroke Patients Receiving tPA Require ICU Admission?
Farid Sadaka1,2, Amar Jadhav1,2, Jacklyn O'Brien1,2
1Mercy Hospital St. Louis, St. Louis, MO, USA.
Journal of Clinical Medicine Research
|February 9, 2018
Summary
Stroke patients receiving tissue-type plasminogen activator (tPA) who are low risk for intensive treatments may not need neuroICU admission. This can optimize resource allocation and reduce healthcare costs.
Area of Science:
- Neurology
- Intensive Care Medicine
- Health Services Research
Background:
- Limited resources necessitate predictive models for neuroICU admission in stroke patients treated with tissue-type plasminogen activator (tPA).
- Identifying patients who benefit from neuroICU care is crucial for efficient resource utilization.
Purpose of the Study:
- To develop and validate a model predicting which stroke patients treated with tPA may not require neuroICU admission.
- To differentiate between low-risk and active treatment groups to inform admission decisions.
Main Methods:
- A predictive model was developed to classify patients based on their likelihood of receiving active life-sustaining treatments on day 1 of ICU admission.
- Patients were categorized into a low-risk monitor (LRM) group (≤10% risk of active treatment) and an active treatment (AT) group.
Main Results:
- The AT group (59 patients) had significantly higher APACHE III scores (62 ± 26 vs. 41 ± 15, P = 0.0008) compared to the LRM group (21 patients).
- The AT group experienced longer ICU length of stay (4.5 ± 4.4 vs. 2.5 ± 1.3 days, P = 0.04) and higher hospital mortality (36% vs. 4.7%, P = 0.02).
- Demographics and NIHSS scores were similar between the LRM and AT groups.
Conclusions:
- Stroke patients identified as low-risk post-tPA may not necessitate admission to a neuroICU.
- This approach can lead to improved resource utilization and cost reduction in stroke patient management.
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