Predictors of functional outcome and hemorrhagic complications in acute ischemic stroke patients treated with intravenous thrombolysis - A retrospective analysis .

Abstract

Intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rt-PA) within 4.5hours is an effective and routine therapy for acute ischemic stroke (AIS). The purpose of the study was to identify predictors of functional outcome at 3months and hemorrhagic complications after IVT. A total of 123 AIS patients treated with intravenous alteplase within 4.5hours after stroke were enrolled. Baseline clinical characteristics, medication and disease history, radiographic and laboratory data were collected. The clinical functional outcome at 3months was measured by the modified Rankin Scale dichotomized at 0-1 (favorable) vs. 2-6 (unfavorable). Hemorrhagic complications were measured within 36hours after IVT. Univariate and multivariate analysis was applied in the study, and the logistic regression identified the predictors for functional outcome at 3months and hemorrhagic complications within 36hours. In univariate analysis, the favorable outcome was significantly associated with short hospitalization, low initial National Institute of Health Stroke Scale scores, previous smoking, previous statin use, and absence of post-stroke cerebral edema or pneumonia. Hemorrhagic complications were significantly associated with high initial NIHSS scores, low platelet count, high D-dimer level, previous atrial fibrillation, and onset seasons (except summer). Multivariate regression analyses identified that seasons (spring and summer), short hospital stays, and absence of post-stroke cerebral edema or pneumonia were the predictors of a favorable functional outcome. Meanwhile, seasons (except summer), low platelet count, and high D-dimer levels were correlation factors for prognosis of high hemorrhagic complications. .