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MJA

A population-based study of thrombolysis for acute stroke in South Australia

Daniel M Fatovich
Med J Aust 2011; 194 (8): . || doi: 10.5694/j.1326-5377.2011.tb03049.x
Published online: 18 April 2011

To the Editor: The report by Leyden and colleagues highlights the value of examining the total experience of stroke thrombolysis in one population.1 The results are devastating: protocol violations in more than a third of cases (consistent with other reports of up to 50%2), and a 10% symptomatic intracranial haemorrhage (ICH) rate (representing a number needed to harm [NNH] of 10). As a clinician, I would be “gutted” if my treatment harmed every 10th patient. The 22% mortality at 3 months is consistent with real-world evidence that stroke thrombolysis increases mortality.3

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