Abstract P31: Intravenous Thrombolysis And Short-term Functional Outcome In Minor Stroke: Observational Study.

Abstract

Background: Identification of predictive factors for favorable functional outcome after acute ischemic stroke is crucial. 1 Minor stroke (MS) is the most common exclusion criteria for intravenous thrombolysis and up to 30% of patients with MS will have a poor functional outcome at 3 months. 2 Objective: We reported the frequency of intravenous thrombolysis in the setting of minor stroke in the population of study and tried to identify clinical factors associated with favorable functional outcomes among these patients. Methods: Fifty-one consecutive patients with acute MS were selected (National Institute of Health Stroke Scale of 5 or less). Functional outcome was assessed using the modified Rankin scale (mRS) at 3 months after index event. Descriptive analysis through frequency and central tendency measures were applied and exact Fisher’s test was used for analysis of categorical variables and logistic regression analysis to determine the impact of independent factors related to functional outcome. Results: 60.8% of patients were males. Hypertension (43.1%) was the most frequent risk factor identified among these patients follow by diabetes (37.5%) and smoking (31.4%). 46.5% of patients presented in the <4.5 hours window for IV thrombolysis of these 4.7% presented within the first hour of symptom onset and only 11.8% were treated with rtPA. None of these patients had intracerebral hemorrhage (ICH). Small vessel disease was the most common cause of MS (37.2%) and no cause was identified in 13.7% of patients after evaluation. Favorable outcome (mRS 0 - 2) was observed in 88.2% of patients and one patient died after recurrence of stroke two weeks after MS. Male sex and time from symptom onset to the emergency department > 24 hours were associated with poor functional outcome (mRS 3 - 6) ( p 0.029 and p 0.014 respectively) without reaching statistical significance in the multivariate analysis. Conclusions: Most patients with MS had a favorable functional outcome (mRS 0 - 2) notwithstanding the low rate of IV thrombolysis compared with other study populations without increasing the risk of ICH in this group of patients. 3 A tendency towards poor functional outcome for male sex and time from symptom onset to the emergency department > 24 hours was observed