Treatment of cerebral infarction at the stroke unit in Bodø 2011-12.

BACKGROUND: The regional health enterprises wish to increase the proportion of cerebral infarction patients who receive intravenous thrombolytic therapy. We have identified the reasons why only very few patients received such treatment during 2011-12. We also wished to assess the benefits of ECG telemetry in the examination of the patients. MATERIAL AND METHOD: With permission from the enterprise's own data protection officer, we analysed data for all patients discharged from the stroke unit at the Department of Neurology, Nordland Hospital, after a cerebral infarction (diagnostic code I63) in the period from 1 January 2011 to 30 April 2012. RESULTS: Of a total of 180 patients admitted directly to the stroke unit, only 12 (6.7%) received intravenous thrombolytic therapy. The main reasons why such treatment was not provided include late arrival at the hospital (n = 91: 50%) and an unknown time of symptom onset (n = 60: 33%). ECG telemetry detected atrial fibrillation in 27 of the 112 patients examined (24%), which meant that anticoagulation treatment was provided to 22 patients who otherwise would have received platelet inhibitors. INTERPRETATION: Half of all patients with cerebral infarction arrived in the hospital too late for provision of intravenous thrombolytic therapy, and in one-third the time of onset could not be determined. In many patients, ECG telemetry led to changes in the choice of secondary prophylaxis.