Outcome in acute ischemic stroke patients treated with intravenous thrombolysis - a retrospective and statistical analysis of five years' experience.

Abstract

This paper represents a retrospective study on 252 patients with acute ischemic stroke (AIS), who received thrombolytic therapy between 2019-2023, in the Department of Neurology at the Emergency County Hospital in Craiova, Romania. We aimed to evaluate treatment complications and short-term outcomes of patients with AIS, treated with intravenous (i.v.) recombinant tissue plasminogen activator (rtPA; Alteplase), within 4.5 hours from onset. We also tried to assess the correlations between classical risk factors, such as diabetes, hypertension, atrial fibrillation, smoking and the outcome of these patients. Two hundred and fifty-two patients were treated with i.v. thrombolysis in our Department between October 2019 and December 2023. Out of the total thrombolysed patients, 146 were men and 106 were women. Our focus was on the clinical evolution of our patients and on the complications, especially on hemorrhagic transformation and death, and we tried to see if there were any correlations between gender, age, vascular risk factors such as diabetes, smoke, obesity, hypertension, atrial fibrillation and the outcome of our thrombolysed patients. Out of the total of 252 thrombolysed patients, only 55 (21.83%) had hemorrhagic transformation. Analyzing the differences between the occurrence of hemorrhagic transformation, respectively death, depending on the location and type of stroke, we did not identify statistically significant differences. The only comparison where a difference close to the significance limit is observed is that related to the frequency of deaths depending on the type of stroke - patients with cardioembolic stroke had a higher death rate.