My mom had the most severe type of stroke. She received TPA and it did cause a bleed. She has severe disabilities. Severe deficits. But I would not hesitate nor do I second guess the chance for TPA. I wish it had worked for her.
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This drug literally saved my Moms life. I had no idea it was contested by some doctors. This is crazy
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Although there are risks involved, I have seen the positive effects of this drug many times if protocol is followed
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2) By the end of the intensive monitoring phase she was speaking clearly and in full sentences. A life worth preserving. It is certainly worth the risk considering the alternatives
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So even Med students getting info from social media not from fundamental research. That seems scary.
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I mean... if you're having a stroke how much worse can it get?
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I think the community of stroke neurologists are the closest to "scientific-consensus" here. No offense to great ER docs everywhere. Stroke neurologists disagree alot, but not about t-PA.
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I am not sure what hospitals you are canvassing? Most hospitals have stroke teams and have had them for years. Stroke team members make the decision and give the medicine. This must be in outlying cities?
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There's no doubt that it works, but as neurosurgeons we also see when it causes a massive haemorrhage. As
@aswinchari said, we should be focusing on thrombectomy now (pulling the clot out of the blood vessel using wires and retrievers)Thanks. Twitter will use this to make your timeline better. UndoUndo
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Furthermore, this isn't just a handful of docs who don't "believe" in a magical treatment that has been proven efficacious beyond doubt; there is significant evidence of harm in the literature, especially studies that are not funded by manufacturers.http://www.thennt.com/nnt/thrombolytics-for-stroke/ …
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"A meta-analysis revealed that industry funding is significantly associated with greater chances of pro-industry results, with an odds ratio of 3.60" This is why public funding of well-designed research into drugs before approval is so damn important.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3236136 …
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We're talking about a stroke right?
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Why are the "skeptics" allowed to make the rules? Medicine should be based on facts and science, not feelings..
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TPA used rarely; radiologists discriminate ischemic v hemorrhagic stroke ~80%. "Too dangerous" due to radiologists fear litigation for H cerebral bleeds (no "call"/no TPA) - ~700,000 ischemic strokes yearly. ~30% arrive on time still don't receive tx TPAhttp://nyti.ms/2IUgzJn
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This is a failure of statistical analysis.
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