A clinical study investigation the three months prognosis of patients with ischemic stroke treated with recombinant tissue plasminogen activator (rtPA) and its effective factors

Abstract

Objective: Currently, treating ischemic stroke by intravenous thrombolytic therapy has acceptable results in patients with stroke. This study aimed to evaluate the three months prognosis of patients treated with recombinant tissue plasminogen activator (rt-PA). Methods: This cross-sectional prospective study was conducted on 30 patients with cerebral ischemic stroke with the National Institutes of Health Stroke Scale (NIHSS) >5. Data such as demographic information, signs and symptoms, medical history, risk factors, focused neurological examination, and the NIHSS were collected for all patients. Then, all patients received 0.9 mg/kg of rt-PA as intravenous bolus doses and intravenous infusion under close monitoring in the emergency department. All patients were checked for necessary outcomes and also disability at the admission time, 7 days later and after three months all patients were checked again. All collected data were analyzed by appropriate tests using SPSS version 22. Results: Of all patients, 63.3% were males and 36.7% were females. The mean age of the patients was 62.37 ± 12.62 years with a range of 40-91 years. The mean of NIHSS was 12.46 ± 4.28 at admission time, in day seven it was 8.06 ± 3.72 and in month three after treatment it was 3.62 ± 2.31. There was a significant relationship between age, place of residence and NIHSS. Thirty percent of patients had NIHSS more than 15 at admission time and after 7 days this rate reached to 10% and three months later it declined to 6.7%. These differences were statistically significant. Conclusion: Intravenous thrombolytic therapy is associated with proper short term results in most patients with ischemic stroke.

Risk Factors Associated with Prognosis in Patients with Acute Stroke: A Retrospective Observational Study

“…The decision for the thrombolytic injection in the ischemic stroke patients depends on variables, such as patient's age, time of hospitalization, systolic blood pressure, diabetes, stroke intensity, comorbidities, and NIHSS (18). The early treatment of the thrombolytic after ischemic stroke (best time: 3-4.5 h) leads to the improvement of the positive effects of treatment and disability induced by the ischemic stroke (19). According to the literature, it is necessary to monitor the patient precisely from the injection to at least 48 h after treatment to reduce the side effects of TPA injection (16)(17)(18)(19)(20).…”