Influencing factors of short-term outcome after intravenous thrombolysis with alteplase in acute ischemic stroke

Abstract

Objective To investigate the influencing factors of short-term outcome after intravenous thrombolysis in patients with acute ischemic stroke. Methods Patients with acute ischemic stroke treated with alteplase intravenous thrombolysis within 4.5 hours of onset at the Department of Neurology, the Second Hospital of Tianjin Medical University from January 2015 to October 2017 were enrolled retrospectively. According to the modified Rankin scale score at discharge or 14 d after thrombolysis, the clinical outcome was assessed, 0-2 was defined as good outcome and >2 was defined as poor outcome. Multivariate logistic regression analysis was used to identify the independent risk factors for poor outcome after intravenous thrombolysis in patients with acute ischemic stroke. Results A total of 94 patients were enrolled, including 40 (42.6%) with poor outcome. Multivariate logistic regression analysis showed that high baseline National Institutes of Health Stroke Scale (NIHSS) score (odds ratio [OR]1.344, 95% confidence interval[CI]1.157-1.562; P<0.001), advanced age (OR 1.082, 95% CI 1.010-1.159; P=0.026), and high blood glucose level (OR 1.259, 95% CI 1.018-1.556; P=0.033) were the independent risk factors for poor outcome. Conclusion High baseline NIHSS score, advanced age, and high baseline blood glucose level were the independent risk factors for poor outcome in patients with acute ischemic stroke after alteplase intravenous thrombolysis. Key words: Stroke; Brain Ischemia; Thrombolytic Therapy; Tissue Plasminogen Activator; Infusions, Intravenous; Treatment Outcome