Factors related to therapeutic outcomes of intravenous thrombolysis in stroke patients with different severity
10.3785/j.issn.1008-9292.2015.01.009
- VernacularTitle:不同严重程度急性缺血性卒中患者静脉溶栓预后的影响因素分析
- Author:
Xiao-Bo YAN
1
;
Sheng ZHANG
;
Shen-Qiang YAN
;
Min LOU
Author Information
1. 浙江大学医学院附属第二医院神经内科
- Keywords:
Atrial fibrillation;
Acute disease;
Brain ischemia/drug therapy;
Stroke /drug therapy;
Thrombolytic therapy;
Hemorrhage;
Prognosis;
Retrospective studies
- From:
Journal of Zhejiang University. Medical sciences
2015;(1):54-60
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the factors related to therapeutic outcomes of intravenous thrombolysis in patients with acute ischemic stroke ( AIS ) of different severity. Methods: Clinical data of patients with AIS treated with intravenous thrombolysis in the Second Affiliated Hospital , Zhejiang University School of Medicine between June 2009 and December 2013 were retrospectively reviewed .According to National Institutes of Health Stroke Scale ( NIHSS ) , patients were categorized as mild stroke (≤8 , n=134 ) , moderate stroke ( 9-15 , n=121 ) and severe stroke (≥16 , n=110 ) .The good outcome was defined as modified Rankin Scale ≤2 .The factors related to functional outcomes and hemorrhagic transformation ( HT) were analyzed and compared among 3 groups.Results:Among 365 enrolled patients , good outcomes in 3 groups were 78 .4% ( 105/134 ) , 47 .9% ( 58/121 ) and 24 .5%( 27/110 ) , respectively.In patients with mild stroke, age (OR=0.937, 95%CI:0.898-0.978;P=0.003), baseline NIHSS (OR=0.732, 95%CI:0.564 -0.950; P =0.019), onset to needle time (ONT) within 270 min (OR=4.109, 95%CI:1.441-11.719;P=0.008 ) independently predicted good outcome , while baseline glucose ( OR =1.326, 95%CI:1.009 -1.743; P =0.043 ) was independently associated with parenchymal hematoma ( PH ) .In patients with moderate stroke , age ( OR =0 .954 , 95%CI: 0.924 -0.984; P =0.003) and baseline NIHSS (OR =0.760, 95%CI:0 .619 -0 .933; P =0 .009 ) independently predicted good outcome , while atrial fibrillation ( OR=3 .307 , 95%CI:1 .140~9 .596; P=0 .028 ) and systolic pressure ( OR=0.967, 95%CI:0.943~0.991;P=0.008) was independently associated with hemorrhagic infaction .Atrial fibrillation ( OR=36 .972 , 95%CI:1 .770-772 .462;P=0 .02 ) was independently associated with PH . In patients with severe stroke , baseline NIHSS (OR=0.808, 95%CI:0.677 -0.963; P =0.018) independently predicted good outcome , while no independent risk factors of HT was found . Conclusion:For different severity of AIS patients , the related factors of functional outcome and HT after thrombolysis were different .
