Awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke_West China Medical Journal

Authors：

YANG Juan ¹ , CAO Yingying ² , HE Lanying ¹ ,  WANG Jian ¹

1. Department of Neurology, the Second People’s Hospital of Chengdu, Chengdu, Sichuan 610017, P. R. China;
2. Department of Neurology, the Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, P. R. China;

Corresponding author：

WANG Jian, Email: jian.wx@163.com

Keywords：

Ischemic stroke; Thrombolytic therapy; Awareness

DOI：

10.7507/1002-0179.201606257

Video：

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Objective To explore the awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke. Methods From January to August 2012, using self-designed questionnaire, trained neurologists conducted the face to face investigation in 500 inpatients with a high risk of stroke, including those with a history of stroke in Department of Neurology in the Second Affiliated Hospital of Chongqing Medical University. Results A total of 467 valid questionnaires were recovered. Only 16.1% (75/467) patients were aware of thrombolytic therapy for acute stroke, of whom 50.7% (38/75) knew the time window of thrombolytic therapy. Awareness of thrombolytic therapy was higher in patients aged 56-70 years, with a higher level of education and income, and in those who knew at least 3 stroke warning signs and those with a history of stroke. While awareness of the time window of thrombolytic therapy was higher in those unmarried or widowed and with a history of stroke. Multiple logistic regression analysis showed that awareness of thrombolytic therapy was independently associated with age, education level, knowledge of stroke warning signs and a history of stroke; awareness of the time window was associated with marital status and a history of stroke (P<0.05). Conclusions Inpatients with a history of stroke and with a high risk of stroke in the Department of Neurology have poor awareness of thrombolytic therapy for acute ischemic stroke. It is necessary to improve the level of patients’ knowledge about thrombolytic therapy for acute stroke by health education.

Citation： YANG Juan, CAO Yingying, HE Lanying, WANG Jian. Awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke. West China Medical Journal, 2017, 32(12): 1849-1853. doi: 10.7507/1002-0179.201606257 Copy

1.	Rudd AG Hoffman A, Grant R, et al. Stroke thrombolysis in England, Wales and Northern Ireland: how much do we do and how much do we need?. J Neurol Neurosurg Psychiatry, 2011, 82(1): 14-19.
2.	Reeves MJ, Rafferty AP, Aranha AA, et al. Changes in knowledge of stroke risk factors and warning signs among Michigan adults. Cerebrovasc Dis, 2008, 25(5): 385-391.
3.	Fussman C, Rafferty AP, Lyon-Callo S, et al. Lack of association between stroke symptom knowledge and intent to call 911: a population-based survey. Stroke, 2010, 41(7): 1501-1507.
4.	Lundelin K, Graciani A, García-Puig J, et al. Knowledge of stroke warning symptoms and intended action in response to stroke in Spain: a nationwide population-based study. Cerebrovasc Dis, 2012, 34(2): 161-168.
5.	Anderson BE, Rafferty AP, Lyon-Callo S, et al. Knowledge of tissue plasminogen activator for acute stroke among Michigan adults. Stroke, 2009, 40(7): 2564-2567.
6.	National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med, 1995, 333(24): 1581-1587.
7.	Sug Yoon S, Heller RF, Levi C, et al. Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke, 2001, 32: 1926-1930.
8.	Pandian JD, Jaison A, Deepak SS, et al. Public awareness of warning symptoms, risk factors and treatment of stroke in northwest India. Stroke 2005, 36: 644-648.
9.	Park MH, Jo SA, Jo I, et al. No differences in stroke knowledge between Korean adherents to traditional and western medicine-the AGE study: an epidemiological study. BMC Public Health 2006, 6: 153.
10.	Jurkowski JM, Maniccia DM, Dennison BA, et al. Awareness of necessity to call 9-1-1 for stroke symptoms New York. Prev Chronic Dis, 2008, 5(2): A41.
11.	Falavigna A, Teles AR, Vedana VM, et al. Awareness of stroke risk factors and warning signs in southern Brazil. Arq Neuropsiquiatr, 2009, 67(4): 1076-1081.
12.	Ellis C, Egede LE. Stroke recognition among individuals with stroke risk factors. Am J Med Sci, 2009, 337: 5-10.
13.	孙海欣, 王文志, 陈胜云, 等. 北京市丰台区社区居民卒中相关知识水平调查. 中国卒中杂志, 2010, 5(8): 630-634.
14.	Sun H, Chen S, Jiang B, et al. Public knowledge of stroke in Chinese urban residents: a community questionnaire study. Neurol Res, 2011, 33(5): 536-540.
15.	中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南 2010. 中华神经科杂志, 2010, 14(12B): 4013-4017.
16.	Morgenstern LB, Steffen-Batey L, Smith MA, et al. Barriers to acute stroke therapy and stroke prevention in Mexican Americans. Stroke, 2001, 32(6): 1360-1364.
17.	Kleindorfer D, Khoury J, Broderick JP, et al. Temporal trends in public awareness of stroke: warning signs, risk factors, and treatment. Stroke, 2009, 40(7): 2502-2506.
18.	Yang J, Zheng M, Chen S, et al. Knowledge of thrombolytic therapy for acute ischemic stroke among community residents in western urban China. PLoS One, 2014, 9(9): e107892.
19.	曹莹莹, 王健, 张杰, 等. 有卒中危险因素的住院患者对卒中症状的认知及急救意识的调查研究. 重庆医科大学学报, 2014, 39(2): 211-216.
20.	Ritter MA, Brach S, Rogalewski A, et al. Discrepancy between theoretical knowledge and real action in acute stroke: self-assessment as an important predictor of time to admission. Neurol Res, 2007, 29(5): 476-479.
21.	Barr J, McKinley S, O’Brien E, et al. Patient recognition of and response to symptoms of TIA or stroke. Neuroepidemiology, 2006, 26(3): 168-175.

1. Rudd AG Hoffman A, Grant R, et al. Stroke thrombolysis in England, Wales and Northern Ireland: how much do we do and how much do we need?. J Neurol Neurosurg Psychiatry, 2011, 82(1): 14-19.
2. Reeves MJ, Rafferty AP, Aranha AA, et al. Changes in knowledge of stroke risk factors and warning signs among Michigan adults. Cerebrovasc Dis, 2008, 25(5): 385-391.
3. Fussman C, Rafferty AP, Lyon-Callo S, et al. Lack of association between stroke symptom knowledge and intent to call 911: a population-based survey. Stroke, 2010, 41(7): 1501-1507.
4. Lundelin K, Graciani A, García-Puig J, et al. Knowledge of stroke warning symptoms and intended action in response to stroke in Spain: a nationwide population-based study. Cerebrovasc Dis, 2012, 34(2): 161-168.
5. Anderson BE, Rafferty AP, Lyon-Callo S, et al. Knowledge of tissue plasminogen activator for acute stroke among Michigan adults. Stroke, 2009, 40(7): 2564-2567.
6. National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med, 1995, 333(24): 1581-1587.
7. Sug Yoon S, Heller RF, Levi C, et al. Knowledge of stroke risk factors, warning symptoms, and treatment among an Australian urban population. Stroke, 2001, 32: 1926-1930.
8. Pandian JD, Jaison A, Deepak SS, et al. Public awareness of warning symptoms, risk factors and treatment of stroke in northwest India. Stroke 2005, 36: 644-648.
9. Park MH, Jo SA, Jo I, et al. No differences in stroke knowledge between Korean adherents to traditional and western medicine-the AGE study: an epidemiological study. BMC Public Health 2006, 6: 153.
10. Jurkowski JM, Maniccia DM, Dennison BA, et al. Awareness of necessity to call 9-1-1 for stroke symptoms New York. Prev Chronic Dis, 2008, 5(2): A41.
11. Falavigna A, Teles AR, Vedana VM, et al. Awareness of stroke risk factors and warning signs in southern Brazil. Arq Neuropsiquiatr, 2009, 67(4): 1076-1081.
12. Ellis C, Egede LE. Stroke recognition among individuals with stroke risk factors. Am J Med Sci, 2009, 337: 5-10.
13. 孙海欣, 王文志, 陈胜云, 等. 北京市丰台区社区居民卒中相关知识水平调查. 中国卒中杂志, 2010, 5(8): 630-634.
14. Sun H, Chen S, Jiang B, et al. Public knowledge of stroke in Chinese urban residents: a community questionnaire study. Neurol Res, 2011, 33(5): 536-540.
15. 中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组. 中国急性缺血性脑卒中诊治指南 2010. 中华神经科杂志, 2010, 14(12B): 4013-4017.
16. Morgenstern LB, Steffen-Batey L, Smith MA, et al. Barriers to acute stroke therapy and stroke prevention in Mexican Americans. Stroke, 2001, 32(6): 1360-1364.
17. Kleindorfer D, Khoury J, Broderick JP, et al. Temporal trends in public awareness of stroke: warning signs, risk factors, and treatment. Stroke, 2009, 40(7): 2502-2506.
18. Yang J, Zheng M, Chen S, et al. Knowledge of thrombolytic therapy for acute ischemic stroke among community residents in western urban China. PLoS One, 2014, 9(9): e107892.
19. 曹莹莹, 王健, 张杰, 等. 有卒中危险因素的住院患者对卒中症状的认知及急救意识的调查研究. 重庆医科大学学报, 2014, 39(2): 211-216.
20. Ritter MA, Brach S, Rogalewski A, et al. Discrepancy between theoretical knowledge and real action in acute stroke: self-assessment as an important predictor of time to admission. Neurol Res, 2007, 29(5): 476-479.
21. Barr J, McKinley S, O’Brien E, et al. Patient recognition of and response to symptoms of TIA or stroke. Neuroepidemiology, 2006, 26(3): 168-175.

West China Medical Journal

Awareness of thrombolytic therapy for acute ischemic stroke in inpatients with a history of stroke and with a high risk of stroke

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