{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:41:54Z","timestamp":1792798914199,"version":"4.5.0"},"reference-count":20,"publisher":"Georg Thieme Verlag KG","issue":"11","license":[{"start":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T00:00:00Z","timestamp":1792713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The effectiveness of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) is time-dependent, and waiting for coagulation tests (COT) may delay treatment initiation. In several countries, IVT is initiated without waiting COT results; this approach has not been evaluated in South America. In this region, excessive alcohol consumption may increase the prevalence of unrecognized chronic liver disease.<\/jats:p>\n                  <jats:p>To determine the frequency of unsuspected coagulation abnormalities among patients with AIS treated with IVT at a single tertiary care center in Chile.<\/jats:p>\n                  <jats:p>A prospective analysis of all patients treated with IVT at Cl\u00ednica Alemana between June 2016 and July 2025, assessing the proportion of individuals with unexpected coagulation abnormalities.<\/jats:p>\n                  <jats:p>A total of 480 patients with AIS received IVT. The COTs were normal in 445 patients (92.7%), abnormal in 9 (1.88%), and incomplete or not performed in 26 (5.42%). No clinical differences were observed among the three groups. Patients with coagulation abnormalities or incomplete\/not performed COT were significantly less frequent in the Emergency Room (ER) during the coronavirus disease 2019 (COVID-19) pandemic (p\u2009=\u20090.001). Among those with abnormal COT results, significant differences were found in international normalized ratio (INR) values (p\u2009&lt;\u20090.000) and platelet count (p\u2009=\u20090.001). The functional outcomes at 3 months, as well as mortality and rate of symptomatic intracerebral hemorrhage, did not differ across groups.<\/jats:p>\n                  <jats:p>Unexpected coagulation disorders are an infrequent finding in patients with AIS treated with IVT at our center in Santiago, Chile. Therefore, blood test results should not be awaited before initiating IVT.<\/jats:p>","DOI":"10.1055\/s-0046-1829030","type":"journal-article","created":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:15:21Z","timestamp":1792797321000},"page":"001-006","source":"Crossref","is-referenced-by-count":0,"title":["Unexpected coagulopathy in thrombolyzed stroke: experience from a single center in Chile"],"prefix":"10.1055","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8376-9450","authenticated-orcid":false,"given":"Alejandro M.","family":"Brunser","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Departamento de Neurolog\u00eda y Psiquiatr\u00eda, Servicio de Neurolog\u00eda, Unidad de Neurolog\u00eda Vascular, Santigo RM, Chile."},{"name":"Universidad del Desarrollo, Facultad de Medicina Cl\u00ednica Alemana, Santiago RM, Chile."},{"name":"Cl\u00ednica Alemana de Santiago, Unidad de Emergencia General, Santiago RM, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0326-930X","authenticated-orcid":false,"given":"Eloy","family":"Mansilla","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Departamento de Neurolog\u00eda y Psiquiatr\u00eda, Servicio de Neurolog\u00eda, Unidad de Neurolog\u00eda Vascular, Santigo RM, Chile."},{"name":"Universidad del Desarrollo, Facultad de Medicina Cl\u00ednica Alemana, Santiago RM, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8978-7590","authenticated-orcid":false,"given":"Martin","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Universidad del Desarrollo, Facultad de Medicina Cl\u00ednica Alemana, Santiago RM, Chile."},{"name":"Cl\u00ednica Alemana de Santiago, Unidad de Emergencia General, Santiago RM, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6425-1613","authenticated-orcid":false,"given":"Luis","family":"Ortega","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Departamento de Neurolog\u00eda y Psiquiatr\u00eda, Servicio de Neurolog\u00eda, Unidad de Neurolog\u00eda Vascular, Santigo RM, Chile."},{"name":"Universidad del Desarrollo, Facultad de Medicina Cl\u00ednica Alemana, Santiago RM, Chile."},{"name":"Cl\u00ednica Alemana de Santiago, Unidad de Emergencia General, Santiago RM, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3558-0266","authenticated-orcid":false,"given":"Gabriel","family":"Cavada","sequence":"additional","affiliation":[{"name":"Universidad del Desarrollo, Facultad de Medicina Cl\u00ednica Alemana, Santiago RM, Chile."},{"name":"Cl\u00ednica Alemana de Santiago, Unidad de Investigaci\u00f3n y Ensayos Cl\u00ednicos, Departamento de Desarrollo Aced\u00e9mico e Investigaci\u00f3n, Santiago RM, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7662-8556","authenticated-orcid":false,"given":"Enrico","family":"Mazzon","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago, Departamento de Neurolog\u00eda y Psiquiatr\u00eda, Servicio de Neurolog\u00eda, Unidad de Neurolog\u00eda Vascular, Santigo RM, Chile."},{"name":"Universidad del Desarrollo, Facultad de Medicina Cl\u00ednica Alemana, Santiago RM, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-6033-3378","authenticated-orcid":false,"given":"Pablo","family":"Gonzalez","sequence":"additional","affiliation":[{"name":"Hospital Biprovincial Quillota, Unidad de Neurolog\u00eda Adultos, Quillota VS, Chile."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,10,23]]},"reference":[{"issue":"9958","key":"ref1","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1016\/S0140-6736(14)60584-5","article-title":"Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials","volume":"384","author":"J Emberson","year":"2014","journal-title":"Lancet"},{"issue":"07","key":"ref2","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1179\/016164107X240035","article-title":"In-hospital delays to stroke thrombolysis: paradoxical effect of early arrival","volume":"29","author":"J G Romano","year":"2007","journal-title":"Neurol Res"},{"issue":"02","key":"ref3","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1093\/ageing\/afh064","article-title":"A systematic review of barriers to delivery of thrombolysis for acute stroke","volume":"33","author":"J Kwan","year":"2004","journal-title":"Age Ageing"},{"issue":"09","key":"ref4","doi-asserted-by":"publisher","first-page":"1665","DOI":"10.1212\/01.wnl.0000244493.13898.5b","article-title":"Predicting abnormal coagulation in ischemic stroke: reducing delay in rt-PA use","volume":"67","author":"R F Gottesman","year":"2006","journal-title":"Neurology"},{"issue":"12","key":"ref5","doi-asserted-by":"publisher","first-page":"e344","DOI":"10.1161\/STR.0000000000000215","article-title":"Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association\/American Stroke Association","volume":"50","author":"W J Powers","year":"2019","journal-title":"Stroke"},{"issue":"04","key":"ref6","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1212\/WNL.0b013e31825d6011","article-title":"Reducing in-hospital delay to 20 minutes in stroke thrombolysis","volume":"79","author":"A Meretoja","year":"2012","journal-title":"Neurology"},{"issue":"03","key":"ref7","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1002\/cld.916","article-title":"Are We Really Taking Care of Alcohol-Related Liver Disease in Latin America?","volume":"16","author":"J P Arab","year":"2020","journal-title":"Clin Liver Dis (Hoboken)"},{"issue":"07","key":"ref8","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1007\/s00234-018-2029-x","article-title":"Diffusion-weighted imaging determinants for acute ischemic stroke diagnosis in the emergency room","volume":"60","author":"A M Brunser","year":"2018","journal-title":"Neuroradiology"},{"issue":"19","key":"ref9","doi-asserted-by":"publisher","first-page":"1795","DOI":"10.1056\/NEJMx200014","article-title":"Thrombolysis guided by perfusion imaging up to 9 hours after onset of stroke","volume":"380","author":"H Ma","year":"2019","journal-title":"N Engl J Med"},{"issue":"07","key":"ref10","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1056\/NEJMoa1804355","article-title":"MRI-guided thrombolysis for stroke with unknown time of onset","volume":"379","author":"G Thomalla","year":"2018","journal-title":"N Engl J Med"},{"issue":"04","key":"ref11","doi-asserted-by":"publisher","first-page":"1169","DOI":"10.1161\/STROKEAHA.111.000527","article-title":"Accuracy of diffusion-weighted imaging in the diagnosis of stroke in patients with suspected cerebral infarct","volume":"44","author":"A M Brunser","year":"2013","journal-title":"Stroke"},{"issue":"13","key":"ref12","doi-asserted-by":"publisher","first-page":"1317","DOI":"10.1056\/NEJMoa0804656","article-title":"Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke","volume":"359","author":"W Hacke","year":"2008","journal-title":"N Engl J Med"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1159\/000504214","article-title":"Safety of Intravenous Thrombolysis for Acute Ischemic Stroke in Patients with Thrombocytopenia","volume":"48","author":"Y F Yang","year":"2019","journal-title":"Cerebrovasc Dis"},{"issue":"23","key":"ref14","doi-asserted-by":"publisher","first-page":"1957","DOI":"10.1212\/WNL.0b013e3181c5b46d","article-title":"Unsuspected coagulopathy rarely prevents IV thrombolysis in acute ischemic stroke","volume":"73","author":"N S Rost","year":"2009","journal-title":"Neurology"},{"issue":"07","key":"ref15","doi-asserted-by":"publisher","first-page":"1414","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.03.021","article-title":"Intravenous Thrombolysis for Acute Ischemic Stroke in Patients with Thrombocytopenia","volume":"26","author":"A Mowla","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"12","key":"ref16","doi-asserted-by":"publisher","first-page":"1407","DOI":"10.1111\/j.1468-1331.2011.03455.x","article-title":"Hemorrhagic complications after systemic thrombolysis in acute stroke patients with abnormal baseline coagulation","volume":"18","author":"F Brunner","year":"2011","journal-title":"Eur J Neurol"},{"issue":"02","key":"ref17","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1111\/imj.13323","article-title":"An audit of coagulation screening in patients presenting to the emergency department for potential stroke thrombolysis","volume":"47","author":"K Thorne","year":"2017","journal-title":"Intern Med J"},{"issue":"01","key":"ref18","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1186\/s12913-025-12798-3","article-title":"Impact of the COVID-19 pandemic on continuity of medical treatment for patients with chronic diseases in Japan: a retrospective cohort analysis","volume":"25","author":"T Ishikawa","year":"2025","journal-title":"BMC Health Serv Res"},{"issue":"06","key":"ref19","doi-asserted-by":"publisher","first-page":"108298","DOI":"10.1016\/j.jstrokecerebrovasdis.2025.108298","article-title":"High mimic rate among recipients of intravenous thrombolysis for acute minor ischemic stroke presenting with disabling symptoms","volume":"34","author":"S Afzal","year":"2025","journal-title":"J Stroke Cerebrovasc Dis"},{"issue":"07","key":"ref20","doi-asserted-by":"publisher","first-page":"1140","DOI":"10.1016\/j.jstrokecerebrovasdis.2012.10.019","article-title":"Exclusion criteria for intravenous thrombolysis in stroke mimics: an observational study","volume":"22","author":"A M Brunser","year":"2013","journal-title":"J Stroke Cerebrovasc Dis"}],"container-title":["Arquivos de Neuro-Psiquiatria"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0046-1829030.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:15:22Z","timestamp":1792797322000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0046-1829030"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,23]]},"references-count":20,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,8,13]]},"published-print":{"date-parts":[[2026,11]]}},"alternative-id":["s00461829030"],"URL":"https:\/\/doi.org\/10.1055\/s-0046-1829030","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0004-282X","1678-4227"],"issn-type":[{"value":"0004-282X","type":"print"},{"value":"1678-4227","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,23]]}}}