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Dosage calculation for intravenous thrombolysis of ischemic stroke: to weigh or to estimate?
journal contribution
posted on 2023-07-26, 14:09 authored by Andreas Ragoschke-Schumm, Asem Razouk, Martin Lesmeister, Stefan Helwig, Iris Q. Grunwald, Klaus FassbenderBackground: 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
7Page range
103-110Publication title
Cerebrovascular Diseases ExtraISSN
1664-5456External DOI
Publisher
Karger PublishersFile version
- Published version
Language
- eng
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Legacy posted date
2017-08-14Legacy creation date
2017-08-14Legacy Faculty/School/Department
ARCHIVED Faculty of Medical Science (until September 2018)Usage metrics
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