Hasnain, GolamPaul, Christine L.Attia, John RRyan, AnnikaKerr, ErinOldmeadow, ChristopherD'Este, CatherineBivard, AndrewHubbard, Isobel JMilton, Abul HasnatLevi, Christopher2022-10-052022-10-051471-2261http://hdl.handle.net/1885/274295Background: Multiple studies have attempted to increase the rate of intravenous thrombolysis for ischemic stroke using interventions to promote adherence to guidelines. Still, many of them did not measure individual-level impact. This study aimed to make a posthoc comparison of the clinical outcomes of patients in the "Thrombolysis ImPlementation in Stroke (TIPS)" study, which aimed to improve rates of intravenous thrombolysis in Australia. Methods: A posthoc analysis was conducted using individual-level patient data. Excellent (Three-month post treatment modified Rankin Score 0-2) and poor clinical outcome (Three-month post treatment modified Rankin Score 5-6) and post treatment parenchymal haematoma were the three main outcomes, and a mixed logistic regression model was used to assess the difference between the intervention and control groups. Results: There was a non-significant higher odds of having an excellent clinical outcome of 57% (odds ratio: 1.57; 95% CI: 0.73-3.39) and 33% (odds ratio: 1.33; 95% CI: 0.73-2.44) during the active-and post-intervention period respectively, for the intervention compared to the control group. A non-significant lower odds of having a poor clinical outcome was also found in the intervention, relative to control group of 4% (odds ratio: 0.96; 95% CI: 0.56- 2.07) and higher odds of having poor outcome of 44% (odds ratio: 1.44 95% CI: 0.61-3.41) during both active and post-intervention period respectively. Similarly, a non-significant lower odds of parenchymal haematoma was also found for the intervention group during the both active- (odds ratio: 0.53; 95% CI: 0.21-1.32) and post-intervention period (odds ratio: 0.96; 95% CI: 0.36-2.52). Conclusion: The TIPS multi-component implementation approach was not effective in reducing the odds of posttreatment severe disability at 90 days, or post-thrombolysis hemorrhage.This study was funded by the National Health and Medical Research Council (NHMRC) partnership grant (569328), part-funded by an NHMRC Practitioner Fellowship (1043913) and NHMRC Translating Research Into Practice fellowship, and included partnership grant contribution funding from Boehringer Ingelheim, in-kind support from Agency for Clinical Innovation Stroke Care Network/Stroke Services New South Wales (NSW), Stroke Foundation and NSW Cardiovascular Research Network-National Heart Foundation, with a cash contribution from the Victorian Stroke Clinical Network and infrastructure funding from the Hunter Medical Research Institute and The University of Newcastle.application/pdfen-AU© The Author(s). 2020 Open Accesshttps://creativecommons.org/licenses/by/4.0/Ischemic strokeIntravenous thrombolysisImplementation interventionClinical outcome202010.1186/s12872-020-01705-92021-11-28Creative Commons Attribution 4.0 International License