A total of 173,033 acute ischemic strokes occurred amongst our hospital network of 178 emergency departments. 344 patients received tenecteplase, 16,219 received alteplase, and 156,470 received no thrombolytic. The median age (68 years), sex (50% female), and income levels were similar across the 3 groups. There were significantly more persons of Black race in the tenecteplase group (P= 0.0005). The 3 groups had similar frequencies of co-morbidities including atrial fibrillation (27%, 23%, 22%), obstructive sleep apnea (5%, 5%, 4%), diabetes (36%, 36%, 38%), prior stroke (13%, 13%, 15%), and hypothyroidism (14%, 14%, 15%). Outcomes across the 3 groups were as follows:
First NIHSS (median =0); discharge NIHSS (median = 0,3,2), with tenecteplase group having the lowest median discharge score. Mortality in the tenecteplase group and no thrombolytic groups was 2%, compared to 3% in the alteplase group. Median hospital length of stay was 3 days for both the tenecteplase and alteplase groups, compared to 2 days for the no thrombolytic group.