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NEUROLOGY 2006;67:1665-1667
© 2006 American Academy of Neurology
Brief Communications

Predicting abnormal coagulation in ischemic stroke: Reducing delay in rt-PA use

Rebecca F. Gottesman, MD, Janice Alt, RN, Robert J. Wityk, MD and Rafael H. Llinas, MD

From the Cerebrovascular Division (R.F.G., R.J.W., R.H.L.), Department of Neurology, Johns Hopkins Medical Institutions; and Department of Neurology (J.A., R.H.L.), Johns Hopkins Bayview Medical Center, Baltimore, MD.

Address correspondence and reprint requests to Dr. Rafael H. Llinas, Department of Neurology, Johns Hopkins Bayview Medical Center, 4940 Eastern Avenue, B122b, Baltimore, MD 21224; e-mail: rllinas{at}jhmi.edu

Normal prothrombin time (PT) and partial thromboplastin time (PTT) are recommended for administration of recombinant tissue-plasminogen activator (rt-PA) in stroke, but waiting for results can delay use. We examined the charts of 365 stroke patients to assess predetermined risk factors associated with elevated PT/PTT. Elevated PT/PTT can be predicted in patients taking warfarin or heparin/heparinoid or on hemodialysis, according to emergency department triage, with 100% sensitivity and 94.7% specificity. These results could be applied to rt-PA candidates and reduce potential delays.

Commentary, see page 1533

Disclosure: The authors report no conflicts of interest.

Received April 10, 2006. Accepted in final form August 22, 2006.


Related Article

November 14 Highlight and Commentary: Eliminating delay in rt-PA administration
Neurology 2006 67: 1533. [Full Text] [PDF]





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