2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

0 500 1000 1500 2000 2500 3000 3500

10

45

63

75

84

101

118

139

157

159

167

31

186

349

532

601

1034

1442

1876

2385

2872

3174

n°pz trt n° centri

Progressione centri attivati vs pz. trattati

Time delay (median min)

Italy All centres

Onset to treating hospital/door time

68.0 75.0

Door to imaging study time

30.0 24.0

Door to treatment/needle time

86.0 65.0

Onset to treatment/needle time

165.0 151.0

Time logistics

Variables Italy All centres

Age 69 70Male 56% 54%Female 44% 46%NIHSS Median 11.0 10.0 NIHSS 0-7 32% 34% NIHSS 8-14 35% 33%NIHSS >15 34% 33%

Current smoker 17% 16%Previous smoker 14% 11%Atrial fibrillation 18% 21%Congestive heart failiure 7% 8%Systolic 150.0 153.0Diastolic 81.0 83.0

Demographic and baseline data

Clinical outcome at 3 monthsmRS 0-2 Recovered

patientsProportion recovered

Lower Confidence

Limit

Upper Confidence

Limit

Italy 971/1594 61,3 58,9 63,7

All centers 3033/5286 58,3 57 59,7

mRS 0-1

Italy 781/1594 49,3 46,9 51,8

All centers 2262/5286 43,5 42,2 44,9

Mortality Dead within 3 months

Proportion Dead

Lower Confidenc

e Limit

Upper Confidence

Limit

Italy 174/1694 10,3 8,9 11,8

All centers 760/6110 12,4 11,6 13,3

Symptomatic intra-cranial hemorrhageSICH definition

SICH patients

Proportion SICH

Lower Confidence

Limit

Upper Confidence

Limit

SITS-MOST

Italy 36/1896 1,9 1,4 2,6

All centers 90/6123 1,5 1,2 1,8

ECASS

Italy 74/1828 4 3,2 5,1

All centers 263/5242 5 4,5 5,6

NINDS

Italy 123/1828 6,7 5,7 8

All centers 367/5242 7 6,3 7,7

Clinical outcome at 3-months (bNIHSS≥10; median 16)

mRS 0-2 N° of patients

Proportion Lower Confidenc

e Limit

Upper Confidenc

e Limit

Italy 335/834 40,5 37,2 43,8

All centers 1055/2762 38,8 37 40,6

mRS 0-1

Italy 233/834 28,1 25,2 31,3

All centers 713/2762 26,2 24,6 27,9

Mortality Dead within 3 months

Proportion Dead

Lower Confidenc

e Limit

Upper Confidenc

e Limit

Italy 149/907 16,4 14,2 19

All centers 622/3290 18,9 17,6 20,3

Quanti pazienti dovremmo trattare?

~50% non trattabili 16.000

≤ 4.5 h50%

~ 65.000

~ 16.000

≤ 3 h30%

≤ 4.5 h50%

~ 5.000 ~ 8.000

~ 1.200 ~ 2.000

Range ~ 10.000 – 18.000 pz./anno

≤ 3 h30%

~ 40.000Trattabili con tPAper RCP ~ 25%

~ 10.000

Nuovi casi 134.000

Totale167.000

Recidive33.000

Incidenza Ictus ischemico in Italia

30%19.500 2.400

21.900

3.174/21.900 = 14.5%