Thrombolytic Therapy in Strokes: A Retrospective Clinical Data Analysis of 40 Patients in a 7-Year Period: The Experience of a Greek Internal Medicine Department

Abstract

Stroke is one of the main causes of mortality and disability in developed countries. In acute ischemic stroke, the standard treatment is recombinant tissue plasminogen activator (rt-PA). The benefits of the treatment depend on the time of administration, the earlier it is administered, the greater its benefit. There are limited studies on the retrospective outcome of thrombolytic therapy in patients with acute ischemic stroke outside of clinical trials. The present retrospective study aimed to analyze the clinical data of 40 patients over 7 years who were hospitalized with acute ischemic stroke at the AHEPA University Hospital in Greece. From January 2013 to December 2020, 40 patients with acute ischemic stroke were admitted and treated. Computed tomography (CT) was performed at 24 h after thrombolytic treatment or earlier in case of neurological worsening. The hospital had 3 months follow-up at the stroke clinic and data consisting of the National Institute of Health Stroke Scale (NIHSS), functional outcome assessed by modified Rankin Scale (mRS) and mortality were reviewed in the medical records from the stroke clinic. The clinical outcome of functional independence defined by the modified Rankin Scale (mRS) ≤ 2 at 3 months was evaluated. Safety outcomes were in-hospital mortality, mortality at 3 months, and symptomatic intracerebral hemorrhage (sICH) defined by the Safe Implementation of Thrombolysis in Stroke-Monitoring Study (SITS-MOST) criteria. The main finding of the present study, that there was an overall reduction in the NIHSS scale after thrombolysis, proves that the patients showed improvement after performing thrombolysis. Consequently, from the total of 40 thrombolysis performed at the clinic, it can be concluded that most patients had a good outcome.