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Outcome of ischemic stroke patients with serious post-thrombolysis neurological deficits
Acta Neurologica Scandinavica, 07/18/2012
Clinical Article
Strbian D et al. – As expected, NIH Stroke Scale (NIHSS) score and patient age showed the strongest association with final outcome in a subpopulation of patients having considerable post–thrombolytic neurological deficit. A relatively high proportion of patients with post–thrombolytic NIHSS 8–9 (10) achieved a favorable 3–month outcome without any further intervention.
Methods- The authors registered 1427 consecutive thrombolysis-treated ischemic stroke patients, of which 473 (33%) had ≥8 NIH Stroke Scale (NIHSS) points after thrombolysis but did not undergo any further rescue intervention.
- They dichotomized them based on 3-month modified Rankin Scale (mRS) to those with favorable (mRS 0–2, n=126, 27%) and unfavorable (mRS 3–6, n=347) outcome.
- Univariate and multivariable methods tested associations of baseline and post-thrombolysis parameters with outcome.
- Lower post-thrombolysis NIHSS score and younger age had strongest association with favorable outcome.
- Most of patients with post-thrombolytic NIHSS score ≥11 achieved unfavorable outcome.
- In contrast, half of patients with favorable outcome had post-thrombolytic NIHSS≤10, and 62% of patients younger than 75 years and having post-thrombolytic NIHSS 8-9 achieved favorable outcome.
- Weaker independent association was observed for blood glucose level and baseline diastolic blood pressure.