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Outcome of ischemic stroke patients with serious post-thrombolysis neurological deficits.

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Title: Outcome of ischemic stroke patients with serious post-thrombolysis neurological deficits.
Authors: Strbian, Daniel, Atula, Sari, Meretoja, Atte, Kaste, Markku, Tatlisumak, Turgut
Source: Acta Neurologica Scandinavica. Apr2013, Vol. 127 Issue 4, p221-226. 6p. 1 Diagram, 4 Charts.
Subjects: Stroke patients, Health outcome assessment, Thrombolytic therapy, Stroke treatment, Neurological research, Endovascular surgery, Interventional radiology
Abstract: Objectives To identify factors associated with favorable outcome in ischemic stroke patients having considerable post-thrombolytic neurological deficits but without endovascular treatment. Materials and methods We registered 1427 consecutive thrombolysis-treated ischemic stroke patients, of which 473 (33%) had ≥8 NIH Stroke Scale (NIHSS) points after thrombolysis but did not undergo any further rescue intervention. We dichotomized them based on 3-month modified Rankin Scale ( mRS) to those with favorable ( mRS 0-2, n = 126, 27%) and unfavorable ( mRS 3-6, n = 347) outcome. Univariate and multivariable methods tested associations of baseline and post-thrombolysis parameters with outcome. Results Lower post-thrombolysis NIHSS score and younger age had strongest association with favorable outcome. Most of patients with post-thrombolytic NIHSS score ≥11 achieved unfavorable outcome. In contrast, half of patients with favorable outcome had post-thrombolytic NIHSS≤10, and 62% of patients younger than 75 years and having post-thrombolytic NIHSS 8-9 achieved favorable outcome. Weaker independent association was observed for blood glucose level and baseline diastolic blood pressure. Conclusions As expected, NIHSS score and patient age showed the strongest association with final outcome in a subpopulation of patients having considerable post-thrombolytic neurological deficit. A relatively high proportion of patients with post-thrombolytic NIHSS 8-9 (10) achieved a favorable 3-month outcome without any further intervention. [ABSTRACT FROM AUTHOR]
Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Outcome of ischemic stroke patients with serious post-thrombolysis neurological deficits.
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  Data: <searchLink fieldCode="AR" term="%22Strbian%2C+Daniel%22">Strbian, Daniel</searchLink><br /><searchLink fieldCode="AR" term="%22Atula%2C+Sari%22">Atula, Sari</searchLink><br /><searchLink fieldCode="AR" term="%22Meretoja%2C+Atte%22">Meretoja, Atte</searchLink><br /><searchLink fieldCode="AR" term="%22Kaste%2C+Markku%22">Kaste, Markku</searchLink><br /><searchLink fieldCode="AR" term="%22Tatlisumak%2C+Turgut%22">Tatlisumak, Turgut</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Acta+Neurologica+Scandinavica%22">Acta Neurologica Scandinavica</searchLink>. Apr2013, Vol. 127 Issue 4, p221-226. 6p. 1 Diagram, 4 Charts.
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  Data: <searchLink fieldCode="DE" term="%22Stroke+patients%22">Stroke patients</searchLink><br /><searchLink fieldCode="DE" term="%22Health+outcome+assessment%22">Health outcome assessment</searchLink><br /><searchLink fieldCode="DE" term="%22Thrombolytic+therapy%22">Thrombolytic therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Stroke+treatment%22">Stroke treatment</searchLink><br /><searchLink fieldCode="DE" term="%22Neurological+research%22">Neurological research</searchLink><br /><searchLink fieldCode="DE" term="%22Endovascular+surgery%22">Endovascular surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Interventional+radiology%22">Interventional radiology</searchLink>
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  Label: Abstract
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  Data: Objectives To identify factors associated with favorable outcome in ischemic stroke patients having considerable post-thrombolytic neurological deficits but without endovascular treatment. Materials and methods We registered 1427 consecutive thrombolysis-treated ischemic stroke patients, of which 473 (33%) had ≥8 NIH Stroke Scale (NIHSS) points after thrombolysis but did not undergo any further rescue intervention. We dichotomized them based on 3-month modified Rankin Scale ( mRS) to those with favorable ( mRS 0-2, n = 126, 27%) and unfavorable ( mRS 3-6, n = 347) outcome. Univariate and multivariable methods tested associations of baseline and post-thrombolysis parameters with outcome. Results Lower post-thrombolysis NIHSS score and younger age had strongest association with favorable outcome. Most of patients with post-thrombolytic NIHSS score ≥11 achieved unfavorable outcome. In contrast, half of patients with favorable outcome had post-thrombolytic NIHSS≤10, and 62% of patients younger than 75 years and having post-thrombolytic NIHSS 8-9 achieved favorable outcome. Weaker independent association was observed for blood glucose level and baseline diastolic blood pressure. Conclusions As expected, NIHSS score and patient age showed the strongest association with final outcome in a subpopulation of patients having considerable post-thrombolytic neurological deficit. A relatively high proportion of patients with post-thrombolytic NIHSS 8-9 (10) achieved a favorable 3-month outcome without any further intervention. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Acta Neurologica Scandinavica is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1111/j.1600-0404.2012.01698.x
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        Text: English
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              Text: Apr2013
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