Assessment of the Functional Status of Patients with Ischaemic Stroke Receiving Thrombolytic Treatment

Abstract

Introduction. Intravenous thrombolysis is a gold standard in the treatment of acute ischaemic stroke. It causes reperfusion in the region of ischaemia and as a result it has a positive effect on functional outcomes of patients. The sooner this treatment is introduced the higher efficacy can be expected. Aim. The study objective was to assess the functional status of patients with ischaemic stroke, undergoing thrombolytic treatment and the incidence of thrombolysis complications. Material and Methods. Retrospective studies were conducted on a group of 109 patients hospitalised due to ischaemic cerebral stroke and qualified for thrombolytic treatment. The functional status was assessed with the use of the modified Rankin Scale and National Institutes of Health Stroke Scales on admission and discharge day. The study group included 55 males and 54 females (respectively: 50.5% and 49.5% of the total study population). The subject age was between 32 and 96 years, with the mean age of 69.8. Results. The average time between the onset of symptoms and initiation of thrombolytic treatment was 182 minutes. The National Institutes of Health Stroke Scale at the moment of qualification for treatment was 10.11 points, and the Rankin Scale was 2.88 points. On the day of discharge, the values were 5.81 and 2.05, respectively. A statistically significant (p < 0.0001) improvement in the functional status was observed in the group of patients who had no intra cerebral haemorrhage after thrombolysis. The most common complication of thrombolytic treatment was haemorrhagic transformation of the ischaemic stroke focus — 27 cases (24.77%). Death occurred in 9 subjects (8.26% of total), including 6 cases in males (10.91% of males) and was related to haemorrhagic transformation of the ischaemic stroke focus (p = 0.000). Conclusions. The implemented treatment of stroke resulted in improvement of the functional status. The most frequent complication was haemorrhagic conversion of stroke. (JNNN 2020;9(1):12–19) Key Words: stroke, thrombolysis, functional status