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Frequency, Risk Factors, and Clinical Significance of Incorrect Dose of Alteplase Due to Weight Estimation in Acute Ischemic Stroke Patients

A Single-Center Retrospective Study

Staszewski, Jacek; Dębiec, Aleksander; Derbich, Marta; Antoniak, Mateusz; Stępień, Adam

Journal of Neuroscience Nursing: October 2019 - Volume 51 - Issue 5 - p 267–272
doi: 10.1097/JNN.0000000000000457
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ABSTRACT Stroke is a clinical emergency requiring urgent recombinant tissue-type plasminogen activator treatment in eligible patients. The dosage of thrombolytic agent (alteplase) is weight dependent. However, many patients receive thrombolytic therapy based on weight estimation. Here, we assess the frequency of incorrect thrombolytic therapy dose as a result of weight estimation and evaluate the short-term safety and efficacy of alteplase misdose. Of 237 patients, weight was estimated in 147 (62%), of which 33 patients (22.4%) were treated with an erroneous dose of alteplase. An incorrect dose was associated with neither poor outcome nor a lower risk of hemorrhage. We conclude that hospitals should implement reliable methods for measuring patients’ weight that could be easily applied and would not cause delays to the treatment of stroke patients.

Questions or comments about this article may be directed to Jacek Staszewski, MD PhD, at jacekstaszewski@wp.pl. He is an Associate Professor, Clinic of Neurology, Military Institute of Medicine, Szaserow 128, 04-141 Warsaw, Poland.

Aleksander Dębiec, MD, is Research Associate, Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland.

Marta Derbich, MD, is Research Associate, Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland.

Mateusz Antoniak, is Research Associate, Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland.

Adam Stępień, is Professor, Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.jnnonline.com).

Online date: July 26, 2019

© 2019 American Association of Neuroscience Nurses