Agreement among stroke faculty and fellows in treating ischemic stroke patients with tissue-type plasminogen activator and thrombectomy

Ahmad Riad Ramadan, Mary Carter Denny, Farhaan S. Vahidy, Jose Miguel Yamal, Tzu Ching Wu, Amrou Sarraj, Sean Savitz, James Grotta

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Background and Purpose - The aim of this study is to determine agreement among vascular neurology fellows and faculty in treating patients with acute ischemic stroke with intravenous tissue-type plasminogen activator and intra-arterial thrombectomy (IAT). Methods - Patients were evaluated simultaneously by at least 2 vascular neurology. Agreement was determined using kappa (κ) and intraclass correlation coefficients. Results - In 60 patients, agreement was substantial for tissue-type plasminogen activator (κ=0.75 [95% confidence interval, 0.57-0.92]) and IAT (κ=0.63 [95% confidence interval, 0.30-0.96]), with no difference between fellow-fellow versus fellow-faculty. Intraclass correlation coefficient for National Institutes of Health Stroke Scale was 0.94 (95% confidence interval, 0.90-0.97) and κ for Alberta Stroke Program Early CT Score was 0.53 (95% confidence interval, 0.20-0.78). Rapidly improving or mild deficits caused disagreement for both tissue-type plasminogen activator and IAT, whereas interpretation of computed tomographic perfusion led to disagreement for IAT. Conclusions - We found substantial agreement between vascular neurology fellows and faculty in treating with tissue-type plasminogen activator or IAT. Areas for improvement include recognition of stroke mimics, consensus on treating less severe strokes, and use/interpretation of imaging.

Original languageEnglish (US)
Pages (from-to)222-224
Number of pages3
JournalStroke
Volume48
Issue number1
DOIs
StatePublished - Jan 1 2017

Keywords

  • faculty
  • quality improvement
  • stroke
  • thrombectomy
  • tissue-type plasminogen activator

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Fingerprint Dive into the research topics of 'Agreement among stroke faculty and fellows in treating ischemic stroke patients with tissue-type plasminogen activator and thrombectomy'. Together they form a unique fingerprint.

Cite this