Abstract
BackgroundOur objective was to find which additional factors can influence the favorable result in stroke patients after receiving fibrinolytic and/or endovascular treatment, quantified as a more than 30% improvement of the NIHSS score at 7 days.MethodsThis is a retrospective study to find factors that could influence a favorable evolution of patients with stroke that underwent fibrinolytic and or thrombectomy using the NIHSS score changes. At the admission in the hospital, blood glucose, blood count, coagulation time, INR, aPTT, PT, platelet count, NIHSS questionnaire and ASPECTS score were collected. NIHSS was assessed at the admission, after 1 h, after 2 h, after 24 h and after 7 days.ResultsAs compared to the initial evaluation, at 7 days after admission 59% (72) of patients have improved with more than 30% the NIHSS. Higher levels of systolic blood pressure, glycemia and lower ASPECTS score at admission were observed in non-achievers. The value of INR contributed to model: for every unit increase of INR, the chance of better outcome decreases by 90,1%. High glycemia has also a negative impact: for every unit increase, the chance of better outcome decreases by 24%. Higher initial ASPECTS score is associated with better outcomes: each point increase of ASPECTS score at initial evaluation, increases the chance of better outcome by 154.2%.ConclusionMales, older age, diabetes, and hyperglycemia correlate with a worse outcome after cerebral stroke regardless of the benefit yielded fibrinolytic and/or thrombectomy therapy. In this study, patients with the above-mentioned factors did not improve more than 30% of baseline NIHSS score from admission to the 7th day.
Highlights
Our objective was to find which additional factors can influence the favorable result in stroke patients after receiving fibrinolytic and/or endovascular treatment, quantified as a more than 30% improvement of the NIHS S score at 7 days
Our objective was to find additional factors that might influence the favorable evolution of patients with stroke after receiving fibrinolytic and/or endovascular treatment, by quantifying it as a more than a 30% improvement of National Institutes of Health Stroke Scale (NIHSS) at day 7
Significant higher proportions of men, patients diagnosed with diabetes mellitus were found in the group that did not succeed to increase with at least 30% the NIHSS at 7 days
Summary
Our objective was to find which additional factors can influence the favorable result in stroke patients after receiving fibrinolytic and/or endovascular treatment, quantified as a more than 30% improvement of the NIHS S score at 7 days. Due to its major socio-economic burden, stroke represents a significant cause of mortality and disability worldwide. Stroke is a complex pathology, and its identification and diagnosis is initially based on the clinical examination of the patient. Intravenous thrombolysis and mechanical thrombectomy are efficacious and safe in patients with acute ischemic stroke, and earlier treatment is associated with better outcome [3]. One of the major risk factors for stroke is represented by diabetes which accounts for approximately 3–20% of stroke risk [4].
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