Trombolys som akutbehandling vid ischemisk stroke sprids över landet. Men regionala variationer är ännu stora, visar Riks-Stroke-analys
Sammanfattning
The Riks-Stroke register was used to explore how thrombolysis has been disseminated in Swedish stroke care. During 2003-2009, 84 371 18-80 year old patients were hospitalized for acute ischemic stroke. Nationwide, the uptake of thrombolysis increased from 0.9 % in 2003 to 7.9 % in 2009. The marked regional differences in thrombolysis rates decreased over time. Non-university hospitals reached a similar proportion of treatment with a 2-3-year delay compared to university hospitals. There was no time trend in symptomatic intracranial hemorrhagic complications. Independent predictors of a high proportion of patients receiving thrombolysis included being treated in a stroke unit and in a department of neurology (as opposed to department of medicine). The proportion of thrombolysis alarms correlated closely with the actual proportion of patients treated. We conclude that the implementation has been performed with preserved patient safety, but it has been fragmented with considerable inequity in the access to thrombolysis.