Effect of Tissue Plasminogen Activator Dose and Interval on Stroke Severity

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Excerpt: The recent study by Sahlas et al1 in the Journal of Stroke and Cerebrovascular Diseases concluded that “the estimation of a patient's weight in the acute setting can lead to overcalculation of the tissue plasminogen activator dose, which is associated with poorer functional outcomes.” However, this conclusion is not well supported by their study1 because the most severe ischemic stroke cases were the ones that were most likely not weighed, and this severity could have led to the increased mortality that was found2 and the majority of unweighed patients were actually given an underdose that was associated with better discharge outcomes, as explained below.