Time of Day, Outcome, and Response to Thrombolytic Therapy: The National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Trial Experience

Does Time of Day Or Physician Experience Affect Outcome of Acute Ischemic Stroke Patients Treated with Thrombolysis? a Study from Finland

“…This is in line with previous studies showing highest rates for stroke onset in the morning (1,19,20). A peak in ICH (19,20and sICH (21) during the morning hours has been reported before but could not be verified in our study. We found increased rates of sICH after thrombolysis in autumn and spring, in accordance to previous reports on primary ICH (3,22).…”

Benefit of thrombolysis for stroke is maintained around the clock: results from the SITS‐EAST Registry

“…Our results are similar to another recent hospital‐based study . Both this and our study could not replicate in clinical practice what was found in a post hoc analysis of the NINDS rtPA Stroke Trial which found a SICH peak for those who received rtPA between 00:00 and 04:00 h. The difference between the NINDS data and other studies can be due to differences between randomized clinical trials versus routine clinical practice. Moreover, the NINDS study sample was rather small (624 patients) compared with our study cohort.…”

“…Higher severity and worse outcome for night and morning strokes have been reported in observational studies . Hospital‐based registries and a post hoc analysis of the NINDS rtPA Stroke Trial have shown that the outcome of patients treated with rtPA was not related to the time of stroke onset . This finding has now been confirmed by our large prospective multicenter thrombolysis register.…”

Is there a bad time for intravenous thrombolysis? The experience of Polish stroke centers

“…Several studies have described the so-called 'weekend phenomenon' [5][6][7][8][9][10][11][12]. Some authors also suggest that patients admitted during out-of-office hours [13,14] or night hours [7,15,16] may achieve less favorable outcome. However, the amount of evidence is still not sufficient, especially regarding treatment with rtPA.…”