Comparative Analysis of Tertiary Stroke Center: Factors Affecting the 3rd Month Clinical Outcome of Patients Treated with Thrombolytic Treatment

Abstract

Objective: In this study, we aimed to document the data of intravenous thrombolytic therapy [intra venous tissue plasminogen activator (iv-tPA)] that we applied to patients admitted to our stroke unit with acute ischemic stroke, and to verify the correlation of these data with the 3rd month modified Rankin Scale (mRS) score. Methods: We enrolled 235 patients in the study who were admitted to Istanbul Medeniyet University Goztepe Prof. Dr. Suleyman Yalcin City Hospital with acute ischemic stroke and received iv-tPA. Demographic data of the patients and stroke risk factors were recorded. Trial of Org 10172 in acute stroke (TOAST) classification for stroke etiology, Bamford stroke classification to define stroke clinic, National Institute of Health Stroke Scale score to evaluate stroke severity, and the Alberta stroke program early CT (ASPECT) score to evaluate the brain tomography of patients before iv-tPA were used. The 3rd month functional outcomes were evaluated with the mRS score. The correlation between all data obtained from the patients and mRS score was examined. Results: Two hundred thirty five patients who received iv-tPA (128 females, 107 males, mean age 72.23 +/- 13.88) were included in the study. It was observed that patients with atrial fibrillation rhythm and patients who developed complications during hospitalization had significantly higher mRS scores. When the relationship between TOAST classification subgroups and mRS score was examined, it was found that the large artery atherosclerosis and cardioembolism groups had higher mRS score than the small vessel disease and undetermined etiology groups. According to the Bamford classification, the total anterior circulation syndrome group had a higher mRS score than all other groups. A negative correlation was detected between ASPECT score and mRS score. Conclusion: As a result of this study, Bamford and TOAST classifications, ASPECT score, the presence of atrial fibrillation rhythm, and the development of complications during hospitalization were important factors in predicting 3rd month disability of the patients who were treated with iv-tPA.