6
|
Gensicke H, Al Sultan AS, Strbian D, Hametner C, Zinkstok SM, Moulin S, Bill O, Zini A, Padjen V, Kägi G, Pezzini A, Seiffge DJ, Traenka C, Räty S, Amiri H, Zonneveld TP, Lachenmeier R, Polymeris A, Roos YB, Gumbinger C, Jovanovic DR, Curtze S, Sibolt G, Vandelli L, Ringleb PA, Leys D, Cordonnier C, Michel P, Lyrer PA, Peters N, Tatlisumak T, Nederkoorn PJ, Engelter ST. Intravenous thrombolysis and platelet count. Neurology 2018; 90:e690-e697. [PMID: 29367438 DOI: 10.1212/wnl.0000000000004982] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 11/15/2017] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To study the effect of platelet count (PC) on bleeding risk and outcome in stroke patients treated with IV thrombolysis (IVT) and to explore whether withholding IVT in PC < 100 × 109/L is supported. METHODS In this prospective multicenter, IVT register-based study, we compared PC with symptomatic intracranial hemorrhage (sICH; Second European-Australasian Acute Stroke Study [ECASS II] criteria), poor outcome (modified Rankin Scale score 3-6), and mortality at 3 months. PC was used as a continuous and categorical variable distinguishing thrombocytopenia (<150 × 109/L), thrombocytosis (>450 × 109/L), and normal PC (150-450 × 109/L [reference group]). Moreover, PC < 100 × 109/L was compared to PC ≥ 100 × 109/L. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) from the logistic regression models were calculated. RESULTS Among 7,533 IVT-treated stroke patients, 6,830 (90.7%) had normal PC, 595 (7.9%) had thrombocytopenia, and 108 (1.4%) had thrombocytosis. Decreasing PC (every 10 × 109/L) was associated with increasing risk of sICH (ORadjusted 1.03, 95% CI 1.02-1.05) but decreasing risk of poor outcome (ORadjusted 0.99, 95% CI 0.98-0.99) and mortality (ORadjusted 0.98, 95% CI 0.98-0.99). The risk of sICH was higher in patients with thrombocytopenic than in patients with normal PC (ORadjusted 1.73, 95% CI 1.24-2.43). However, the risk of poor outcome (ORadjusted 0.89, 95% CI 0.39-1.97) and mortality (ORadjusted 1.09, 95% CI 0.83-1.44) did not differ significantly. Thrombocytosis was associated with mortality (ORadjusted 2.02, 95% CI 1.21-3.37). Forty-four (0.3%) patients had PC < 100 × 109/L. Their risks of sICH (ORunadjusted 1.56, 95% CI 0.48-5.07), poor outcome (ORadjusted 1.63, 95% CI 0.82-3.24), and mortality (ORadjusted 1.38, 95% CI 0.64-2.98) did not differ significantly from those of patients with PC ≥ 100 × 109/L. CONCLUSION Lower PC was associated with increased risk of sICH, while higher PC indicated increased mortality. Our data suggest that PC modifies outcome and complications in individual patients, while withholding IVT in all patients with PC < 100 × 109/L is challenged.
Collapse
Affiliation(s)
- Henrik Gensicke
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland.
| | - Abdulaziz S Al Sultan
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Daniel Strbian
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Christian Hametner
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Sanne M Zinkstok
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Solène Moulin
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Olivier Bill
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Andrea Zini
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Visnja Padjen
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Georg Kägi
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Alessandro Pezzini
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - David J Seiffge
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Christopher Traenka
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Silja Räty
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Hemasse Amiri
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Thomas P Zonneveld
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Romina Lachenmeier
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Alexandros Polymeris
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Yvo B Roos
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Christoph Gumbinger
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Dejana R Jovanovic
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Sami Curtze
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Gerli Sibolt
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Laura Vandelli
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Peter A Ringleb
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Didier Leys
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Charlotte Cordonnier
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Patrik Michel
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Philippe A Lyrer
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Nils Peters
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Turgut Tatlisumak
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Paul J Nederkoorn
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | - Stefan T Engelter
- From the Stroke Center and Department of Neurology (H.G., D.J.S., C.T., R.L., A. Polymeris, P.A.L., N.P., S.T.E.), University Hospital Basel and University of Basel, Switzerland; Department of Clinical Neurosciences (H.G., A.S.A.S.), University of Calgary, Alberta, Canada; Department of Neurology (D.S., S.R., S.C., G.S., T.T.), Helsinki University Central Hospital, Finland; Department of Neurology (C.H., H.A., C.G., P.A.R.), University Hospital Heidelberg, Germany; Department of Neurology (S.M.Z., T.P.Z., Y.B.R., P.J.N.), Academic Medical Center, Amsterdam, the Netherlands; University Lille (S.M., D.L., C.C.), Inserm, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, France; Department of Neurology (O.B., P.M.), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland; Stroke Unit (A.Z., L.V.), Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, AUSL Modena, Italy; Neurology Clinic (V.P., D.R.J.), Clinical Centre of Serbia, Belgrade; Department of Neurology (G.K.), Kantonsspital St. Gallen, Switzerland; Department of Clinical and Experimental Sciences (A. Pezzini), Neurology Clinic, University of Brescia, Italy; Medical Faculty (D.R.J.), University of Belgrade, Serbia; Institute of Neuroscience and Physiology (T.T.), Sahlgrenska Academy at University of Gothenburg; Department of Neurology (T.T.), Sahlgrenska University Hospital, Gothenburg, Sweden; and Neurorehabilitation Unit (S.T.E.), University of Basel and University Center for Medicine of Aging and Rehabilitation, Felix Platter Hospital, Switzerland
| | | |
Collapse
|
8
|
Spaander FH, Zinkstok SM, Baharoglu IM, Gensicke H, Polymeris A, Traenka C, Hametner C, Ringleb P, Curtze S, Martinez-Majander N, Aarnio K, Nolte CH, Scheitz JF, Leys D, Hochart A, Padjen V, Kägi G, Pezzini A, Michel P, Bill O, Zini A, Engelter ST, Nederkoorn PJ. Sex Differences and Functional Outcome After Intravenous Thrombolysis. Stroke 2017; 48:699-703. [DOI: 10.1161/strokeaha.116.014739] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 12/05/2016] [Accepted: 12/07/2016] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
Women have a worse outcome after stroke compared with men, although in intravenous thrombolysis (IVT)–treated patients, women seem to benefit more. Besides sex differences, age has also a possible effect on functional outcome. The interaction of sex on the functional outcome in IVT-treated patients in relation to age remains complex. The purpose of this study was to compare outcome after IVT between women and men with regard to age in a large multicenter European cohort reflecting daily clinical practice of acute stroke care.
Methods—
Data were obtained from IVT registries of 12 European tertiary hospitals. The primary outcome was poor functional outcome, defined as a modified Rankin scale score of 3 to 6 at 3 months. We stratified outcome by age in decades. Safety measures were symptomatic intracranial hemorrhage and mortality at 3 months.
Results—
In this cohort, 9495 patients were treated with IVT, and 4170 (43.9%) were women with a mean age of 71.9 years. After adjustments for baseline differences, female sex remained associated with poor functional outcome (odds ratio, 1.15; 95% confidence interval, 1.02–1.31). There was no association between sex and functional outcome when data were stratified by age. Symptomatic intracranial hemorrhage rate was similar in both sexes (adjusted odds ratio, 0.93; 95% confidence interval, 0.73–1.19), whereas mortality was lower among women (adjusted odds ratio, 0.83; 95% confidence interval, 0.70–0.99).
Conclusions—
In this large cohort of IVT-treated patients, women more often had poor functional outcome compared with men. This difference was not dependent on age.
Collapse
Affiliation(s)
- Fianne H. Spaander
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Sanne M. Zinkstok
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Irem M. Baharoglu
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Henrik Gensicke
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Alexandros Polymeris
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Christopher Traenka
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Christian Hametner
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Peter Ringleb
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Sami Curtze
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Nicolas Martinez-Majander
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Karoliina Aarnio
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Christian H. Nolte
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Jan F. Scheitz
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Didier Leys
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Anais Hochart
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Visnja Padjen
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Georg Kägi
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Alessandro Pezzini
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Patrik Michel
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Olivier Bill
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Andrea Zini
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Stefan T. Engelter
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| | - Paul J. Nederkoorn
- From the Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (F.H.S., S.M.Z., I.M.B., P.J.N.); Stroke Center and Department of Neurology, University Hospital Basel, Switzerland (H.G., A.P., C.T., S.T.E.); Department of Neurology, University Hospital Heidelberg, Germany (C.H., P.R.); Department of Neurology, Helsinki University Central Hospital, Finland (S.C., N.M.-M., K.A.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Germany
| |
Collapse
|
13
|
Gensicke H, Strbian D, Zinkstok SM, Scheitz JF, Bill O, Hametner C, Moulin S, Zini A, Kägi G, Pezzini A, Padjen V, Béjot Y, Corbiere S, Zonneveld TP, Seiffge DJ, Roos YB, Traenka C, Putaala J, Peters N, Bonati LH, Curtze S, Erdur H, Sibolt G, Koch P, Vandelli L, Ringleb P, Leys D, Cordonnier C, Michel P, Nolte CH, Lyrer PA, Tatlisumak T, Nederkoorn PJ, Engelter ST. Intravenous Thrombolysis in Patients Dependent on the Daily Help of Others Before Stroke. Stroke 2016; 47:450-6. [DOI: 10.1161/strokeaha.115.011674] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background and Purpose—
We compared outcome and complications in patients with stroke treated with intravenous thrombolysis (IVT) who could not live alone without help of another person before stroke (dependent patients) versus independent ones.
Methods—
In a multicenter IVT-register–based cohort study, we compared previously dependent (prestroke modified Rankin Scale score, 3–5) versus independent (prestroke modified Rankin Scale score, 0–2) patients. Outcome measures were poor 3-month outcome (not reaching at least prestroke modified Rankin Scale [dependent patients]; modified Rankin Scale score of 3–6 [independent patients]), death, and symptomatic intracranial hemorrhage. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (OR [95% confidence interval]) were calculated.
Results—
Among 7430 IVT-treated patients, 489 (6.6%) were dependent and 6941 (93.4%) were independent. Previous stroke, dementia, heart, and bone diseases were the most common causes of preexisting dependency. Dependent patients were more likely to die (OR
unadjusted
, 4.55 [3.74–5.53]; OR
adjusted
, 2.19 [1.70–2.84]). Symptomatic intracranial hemorrhage occurred equally frequent (4.8% versus 4.5%). Poor outcome was more frequent in dependent (60.5%) than in independent (39.6%) patients, but the adjusted ORs were similar (OR
adjusted
, 0.95 [0.75–1.21]). Among survivors, the proportion of patients with poor outcome did not differ (35.7% versus 31.3%). After adjustment for age and stroke severity, the odds of poor outcome were lower in dependent patients (OR
adjusted
, 0.64 [0.49–0.84]).
Conclusions—
IVT-treated stroke patients who were dependent on the daily help of others before stroke carry a higher mortality risk than previously independent patients. The risk of symptomatic intracranial hemorrhage and the likelihood of poor outcome were not independently influenced by previous dependency. Among survivors, poor outcome was avoided at least as effectively in previously dependent patients. Thus, withholding IVT in previously dependent patients might not be justified.
Collapse
Affiliation(s)
- Henrik Gensicke
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Daniel Strbian
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Sanne M. Zinkstok
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Jan F. Scheitz
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Olivier Bill
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Christian Hametner
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Solène Moulin
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Andrea Zini
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Georg Kägi
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Alessandro Pezzini
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Visnja Padjen
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Yannick Béjot
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Sydney Corbiere
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Thomas P. Zonneveld
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - David J. Seiffge
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Yvo B. Roos
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Christopher Traenka
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Jukka Putaala
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Nils Peters
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Leo H. Bonati
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Sami Curtze
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Hebun Erdur
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Gerli Sibolt
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Peter Koch
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Laura Vandelli
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Peter Ringleb
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Didier Leys
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Charlotte Cordonnier
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Patrik Michel
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Christian H. Nolte
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Philippe A. Lyrer
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Turgut Tatlisumak
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Paul J. Nederkoorn
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | - Stefan T. Engelter
- From the Stroke Center and Department of Neurology, University Hospital Basel, Basel, Switzerland (H.G., S.C., D.J.S., C.T., N.P., L.H.B., P.A.L., S.T.E.); Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland (D.S., J.P., S.C., G.S., T.T.); Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands (S.M.Z., T.P.Z., Y.B.R., P.J.N.); Department of Neurology and Center for Stroke Research, Charité-Universitätsmedizin Berlin, Berlin, Germany (J.F.S., H.E., P
| | | |
Collapse
|