Table 3 Thrombolysis contraindications achieved by GDL rules
Thrombolysis contraindication | Represented in GDL (yes/no) |
|---|---|
Stroke onset more than 4.5 hours ago | Yes |
Symptom presentation suggesting another aetiology than that of stroke and/or the patient recovered within 30 minutes | No |
Unclear stroke symptoms | No |
National Institutes of Health Stroke Scale (NIHSS) score higher than 25 | Yes |
CT scan shows haemorrhage | Yes |
CT scan shows major stroke that covers more than 30% of the middle cerebral artery | No |
Blood glucose is lower than 3 mmol/litre or higher than 22 mmol/litre | Yes |
Blood pressure is higher than 185/110 mmHg despite two attempts of intravenous beta-blocking bolus treatment (approximately 20 mg of Labetalol per bolus) | No |
History of cerebral haemorrhage or intracranial bleeding | Yes |
Patient describes an explosive headache (that resembles a subarachnoid haemorrhage) | Yes |
Ongoing or recent severe haemorrhage (extracranial or intracranial) | No |
Likely postictal paresis | Yes |
Suspected septic shock | Yes |
Bleeding disorder or anticoagulation treatment | Yes |
One of the following: infectious endocarditis, pericarditis, ventricular thrombosis, atrial septal aneurysm, severe heart failure, pancreatitis, severe liver damage | Yes |
One of the following in the last week: lumbar puncture, central venous catheter | Yes |
One of the following in the last month: operation/biopsy from parenchymatous organs, trauma with internal injuries, duodenal ulcer, bleeding from the urinary tract | Yes |
One of the following in the last three months: stroke, head trauma, operation in the central nervous system, definite gastrointestinal bleeding | Yes |
Pregnancy, childbirth in the last month, breastfeeding (relative contraindications) | Yes |