Stroke is one of the leading causes of morbidity and mortality worldwide, and since the approval of intravenous thrombolysis (IVT) with recombinant tissue plasminogen activator (rtPA, alteplase) in 1996 1 as a treatment option, acute stroke management has experienced a paradigm shift. Focus has moved to prompt and accurate diagnosis followed by time-sensitive administration of a therapy that effectively and safely restores blood flow to the affected vascular territory.Unfortunately, not all patients improve with IVT, and roughly 50% of treated patients will experience a favorable outcome (independence in activities of daily life and modified Rankin Scale score 0-2) 2 . Mechanical thrombectomy as an adjunct treatment has emerged as a rescue therapy for patients with proximal occlusion of major intracerebral arteries, but it is still not readily available in most countries. Hence, our objective was to identify simple and largely available clinical and ABSTRACTObjective: We aimed to develop a model to predict unfavorable outcome in patients with acute ischemic stroke treated with intravenous thrombolytic therapy (IVT), based on simple variables present on admission. Methods: Retrospective analysis of acute ischemic stroke patients treated with IVT in a hospital in Rio de Janeiro. Clinical and radiographic variables were selected for analysis.Multivariate logistic regression was used to develop a predictive model. Results: We analyzed a total of 82 patients. Median National Institutes of Health Stroke Scale (NIHSS) on admission was 9 (3-22), 40.2% presented with a hyperdense artery sign (HAS), 62% had identifiable early parenchymal changes and 61.6% experienced a favorable outcome. An NIHSS score of > 12 on arrival, age > 70 and the presence of HAS were associated with the outcome, even after correction in a logistic regression model. Conclusion: An NIHSS > 12 on arrival, presence of HAS and age > 70 years were predictors of unfavorable outcome at three months in patients with acute ischemic stroke treated with IVT.Keywords: stroke; thrombolytic therapy; forecasting. RESUMOObjetivo: Desenvolver um modelo para predizer desfecho desfavorável em pacientes com acidente vascular cerebral isquêmico (AVCi) agudo tratados com terapia trombolítica intravenosa (TTI), baseado em variáveis simples presentes à admissão. Métodos: Análise retrospectiva de casos de AVCi tratados com TTI em um hospital no Rio de Janeiro. Variáveis clínicas e radiográficas foram selecionadas para análise. Foi utilizada regressão logística para desenvolver modelo preditivo. Resultados: 82 casos foram analisados. A mediana de escore de National Institutes of Health Stroke Scale (NIHSS) na admissão foi 9 (3-22), 40,2% se apresentaram com sinal da artéria hiperdensa (SAH), 62% possuíam alterações parenquimatosas precoces e 61,6% obtiveram um desfecho favorável. NIHSS > 12, idade > 70 e a presença de SAH foram associados com o desfecho, mesmo após correção em modelo de regressão logística. Conclusão: NIHSS > 12, a presença de SAH e idade maior que 70 ano...
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