Department of Neurology, Dumlupınar University Faculty of Medicine, Kütahya, Turkey.
Department of Neurosurgery, Dumlupınar University Faculty of Medicine, Kütahya, Turkey.
Clin Appl Thromb Hemost. 2018 Dec;24(9_suppl):171S-177S. doi: 10.1177/1076029618796317. Epub 2018 Sep 13.
The objective of our study is to detect the patient group that will most benefit from intravenous (IV) thrombolytic therapy by showing predictive factors of good functional outcomes. The present study covers 88 patients who were admitted to our clinic within the first 4.5 hours from the onset of stroke symptoms, diagnosed with acute ischemic stroke and who received IV thrombolytic therapy between May 2014 and June 2017 as a result of a retrospective analysis of a database prospectively collected. The patients with a score of ≤2 on modified Rankin scale within 3 months were accepted as good functional outcome and those with a score of >2 were accepted as poor functional outcome. As a result, within the period of 3 months posttreatment, good functional outcomes were obtained in 45 (51.1%) patients and poor functional outcomes were obtained in 43 (48.9%) patients. In comparisons, cardioembolic stroke group was statistically significantly higher in the good functional outcome group ( = .03). Pretreatment National Institute of Health Stroke Scale (NIHSS) scores ( < .001), presence of proximal hyperintense middle cerebral artery sign in noncontrast computed brain tomography ( = .03), and being aged ≥80 and older ( = .04) were markedly higher in the group with poor functional outcomes. In conclusion, our study demonstrated that cardioembolic strokes may have an impact on good functional outcomes and being aged 80 and older, presence of proximal HMCAS in computed brain tomography, and pretreatment NIHSS scores may have an impact on poor functional outcomes.
我们的研究目的是通过显示良好功能结局的预测因素,来检测最能从静脉(IV)溶栓治疗中获益的患者群体。本研究涵盖了 88 名患者,这些患者在症状发作后 4.5 小时内被收入我院,经诊断为急性缺血性脑卒中,并在 2014 年 5 月至 2017 年 6 月期间因对前瞻性收集的数据库进行回顾性分析而接受 IV 溶栓治疗。在 3 个月内改良 Rankin 量表评分≤2 的患者被认为是良好的功能结局,评分>2 的患者被认为是不良的功能结局。结果,在治疗后 3 个月内,45 名(51.1%)患者获得了良好的功能结局,43 名(48.9%)患者获得了不良的功能结局。相比之下,心源性脑栓塞组在良好的功能结局组中具有统计学显著意义(=0.03)。治疗前国立卫生研究院卒中量表(NIHSS)评分(<0.001)、非对比计算机脑 CT 中存在近端大脑中动脉高信号征(=0.03)和年龄≥80 岁(=0.04)在不良功能结局组中明显更高。总之,我们的研究表明,心源性脑栓塞可能对良好的功能结局有影响,而年龄≥80 岁、计算机脑 CT 中存在近端大脑中动脉高信号征、治疗前 NIHSS 评分可能对不良功能结局有影响。