Anglia Ruskin Research Online (ARRO)
Browse
Grunwald_2017.pdf (631.14 kB)

Dosage calculation for intravenous thrombolysis of ischemic stroke: to weigh or to estimate?

Download (631.14 kB)
journal contribution
posted on 2023-07-26, 14:09 authored by Andreas Ragoschke-Schumm, Asem Razouk, Martin Lesmeister, Stefan Helwig, Iris Q. Grunwald, Klaus Fassbender
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.

History

Refereed

  • Yes

Volume

7

Page range

103-110

Publication title

Cerebrovascular Diseases Extra

ISSN

1664-5456

Publisher

Karger Publishers

File version

  • Published version

Language

  • eng

Legacy posted date

2017-08-14

Legacy creation date

2017-08-14

Legacy Faculty/School/Department

ARCHIVED Faculty of Medical Science (until September 2018)

Usage metrics

    ARU Outputs

    Categories

    No categories selected

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC