Usefulness of Checking Platelet Count Before Thrombolysis in Acute Ischemic Stroke

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Abstract
Background and Purpose— Thrombolysis for acute ischemic stroke is strikingly time sensitive. Current guidelines require confirmation of a platelet count ≥100 000 before thrombolysis; however, obtaining this laboratory test may delay treatment. Methods— We queried our hospital database to identify patients with ICD-9 codes consistent with acute ischemic stroke from 2000 to 2005 and to determine platelet counts in these patients. Medical charts of patients with platelet counts <100 000 were reviewed to determine whether the patient had a known history of thrombocytopenia or conditions associated with thrombocytopenia. Results— A total of 1752 patients were identified, and 82 (4.7%) had a platelet count <100 000 at stroke onset. Only 6/1752 (0.3%) had a platelet count <100 000 which was not suspected based on initial history. All of these 6 patients had only mildly decreased platelet counts. Conclusions— An unsuspected platelet count <100 000 was found in 0.3% of patients at stroke presentation. In patients ...