Stroke-Related Factors Influencing Thrombolysis Eligibility and Outcomes.

Abstract

Objective: Intravenous thrombolysis (IVT) improves outcomes of acute ischemic stroke (AIS) when timely administered. The aim of this study was to collect and analyze data of stroke-related factors which may influence the performance of stroke-related rescue chains, the use of IVT, and patients' outcomes.

Methods: This study enrolled patients with AIS admitted to our Stroke Unit (SU) between January 1, 2023, and December 31, 2023. We investigated whether age, occurrence of baseline disabling deficits, stroke severity, or stroke location influenced the median Onset-to-Door Time (ODT), the chance of receiving IVT, or the outcomes of AIS in our facility.

Results: A total of 208 patients were enrolled. Patients who received IVT had higher baseline National Institute of Health Stroke Scale (NIHSS) scores (12.26±1.2) than those who did not (6.77±0.51) (P<0.0001). Patients with IVT further showed a greater strength deficit, less ataxia, and lower median ODT (108±20 min) than patients with NO IVT (720±67) (P<0.0001). Weakness of the lower limbs and higher total NIHSS predicted ODT≤ 3.5 hours and the use of IVT. Ataxia and Posterior Circulation Stroke slowed the rescue chain and were negatively correlated with the use of IVT.

Conclusions: Stroke-related factors may slow the rescue chain and affect the application of IVT for AIS. New evaluation strategies are warranted to overcome the detrimental effects of these factors and to allow clinicians to effectively manage strokes of any severity and location.