Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate
Background: Estimation is a widely used method of assessing the weight of patients with acute stroke. Because the dosage of tissue plasminogen activator (tPA) is weight-dependent, errors in estimation lead to incorrect dosing. Methods: We installed a ground-level scale in the computed tomography (CT...
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doaj-4a3ec021dc5643a190ce2b6bd91c0fc82020-11-25T03:41:36ZengKarger PublishersCerebrovascular Diseases Extra1664-54562017-05-017210311010.1159/000474955474955Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to EstimateAndreas Ragoschke-SchummAsem RazoukMartin LesmeisterStefan HelwigIris Q. GrunwaldKlaus FassbenderBackground: Estimation is a widely used method of assessing the weight of patients with acute stroke. Because the dosage of tissue plasminogen activator (tPA) is weight-dependent, errors in estimation lead to incorrect dosing. Methods: We installed a ground-level scale in the computed tomography (CT) suite of our hospital and also integrated a scale into the CT table of our Mobile Stroke Unit in order to prospectively assess the differences between reported, estimated, and measured weights of acute stroke patients. An independent rater asked patients to report their weight. The patients’ weights were also estimated by the treating physician and measured with a scale. Differences between reported, estimated, and measured weights were analyzed statistically. Results: For 100 consecutive patients, weighing was possible without treatment delays. Weights estimated by the physician diverged from measured weights by 10% or more for 27 patients and by 20% or more for 6 patients. Weights reported by the patient diverged from measured weights by 10% or more for 12 patients. Weights reported by the patients differed significantly less from measured weights (mean, 4.1 ± 3.1 kg) than did weights estimated by the physician (5.7 ± 4.4 kg; p = 0.003). Conclusion: This first prospective study of weight assessment in acute stroke shows that the use of an easily accessible scale makes it feasible to weigh patients with acute stroke without the treatment delay associated with additional patient transfers. Physicians’ estimates of patients’ weights demonstrated substantial aberrations from measured weights. Avoiding these deviations would improve the accuracy of tPA dosage.http://www.karger.com/Article/FullText/474955Stroke teamsAcute stroke treatmentIschemic strokeClinical trialTissue plasminogen activatorThrombolysisWeight |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Andreas Ragoschke-Schumm Asem Razouk Martin Lesmeister Stefan Helwig Iris Q. Grunwald Klaus Fassbender |
spellingShingle |
Andreas Ragoschke-Schumm Asem Razouk Martin Lesmeister Stefan Helwig Iris Q. Grunwald Klaus Fassbender Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate Cerebrovascular Diseases Extra Stroke teams Acute stroke treatment Ischemic stroke Clinical trial Tissue plasminogen activator Thrombolysis Weight |
author_facet |
Andreas Ragoschke-Schumm Asem Razouk Martin Lesmeister Stefan Helwig Iris Q. Grunwald Klaus Fassbender |
author_sort |
Andreas Ragoschke-Schumm |
title |
Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate |
title_short |
Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate |
title_full |
Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate |
title_fullStr |
Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate |
title_full_unstemmed |
Dosage Calculation for Intravenous Thrombolysis of Ischemic Stroke: To Weigh or to Estimate |
title_sort |
dosage calculation for intravenous thrombolysis of ischemic stroke: to weigh or to estimate |
publisher |
Karger Publishers |
series |
Cerebrovascular Diseases Extra |
issn |
1664-5456 |
publishDate |
2017-05-01 |
description |
Background: Estimation is a widely used method of assessing the weight of patients with acute stroke. Because the dosage of tissue plasminogen activator (tPA) is weight-dependent, errors in estimation lead to incorrect dosing. Methods: We installed a ground-level scale in the computed tomography (CT) suite of our hospital and also integrated a scale into the CT table of our Mobile Stroke Unit in order to prospectively assess the differences between reported, estimated, and measured weights of acute stroke patients. An independent rater asked patients to report their weight. The patients’ weights were also estimated by the treating physician and measured with a scale. Differences between reported, estimated, and measured weights were analyzed statistically. Results: For 100 consecutive patients, weighing was possible without treatment delays. Weights estimated by the physician diverged from measured weights by 10% or more for 27 patients and by 20% or more for 6 patients. Weights reported by the patient diverged from measured weights by 10% or more for 12 patients. Weights reported by the patients differed significantly less from measured weights (mean, 4.1 ± 3.1 kg) than did weights estimated by the physician (5.7 ± 4.4 kg; p = 0.003). Conclusion: This first prospective study of weight assessment in acute stroke shows that the use of an easily accessible scale makes it feasible to weigh patients with acute stroke without the treatment delay associated with additional patient transfers. Physicians’ estimates of patients’ weights demonstrated substantial aberrations from measured weights. Avoiding these deviations would improve the accuracy of tPA dosage. |
topic |
Stroke teams Acute stroke treatment Ischemic stroke Clinical trial Tissue plasminogen activator Thrombolysis Weight |
url |
http://www.karger.com/Article/FullText/474955 |
work_keys_str_mv |
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