The Correlation Study Of Intravenous Thrombolysiss Ending And The Severity Ischemic Stroke

ObjectiveTo observe the influential factors of outcomes in patients with acute ischemic stroke (AIS) of different severity treated with intravenous thrombolysis.MethodsWe retrospectively reviewed our collected clinical and radiologic data in patients with AIS receiving intravenous thrombolysis therapy in our hospital between June2009and December2013.According to National Institutes of Health Stroke Scale(NIHSS) severity, we categorized patients into mild stroke (NIHSS<8),moderate stroke (NIHSS9-15),and severe stroke(NIHSS>16),and then analyzed the influential factors of long-term outcome (favorable outcome was defined as modified Rankin Scale (mRS)≤2) and HT, including hemorrhagic infarction (HI) and parenchymal hematoma (PH) based on European Cooperative acute stroke study Ⅱ (EC ASS Ⅱ) criteria, respectively.ResultsAmong365enrolled patients,134(36.7%) were mild,121(33.2%) were moderate, and110(30.1%)were severe. In patients with mild stroke, age(OR=0.936,95%CI:0.895～0.978; P=0.003), baseline NIHSS(OR=0.725,95%CI:0.555～0.946; P=0.018), onset to needle time(ONT) within300mins (OR=5.853,95%CI:1.836～18.655; P=0.003) independently predicted favorable outcome, while baseline glucose (OR=1.326,95%CI:1.009～1.743; P=0.043) was independently associated with PH. In patients with moderate stroke, age (OR=0.954,95%CI:0.924～0.984; P=0.003) and baseline NIHSS (OR=0.760,95%CI:0.619～0.933; P=0.009) independently predicted favorable outcome, while atrial fibrillation (OR=36.972,95%CI:1.770～772.462; P=0.02) was independently associated with PH. In patients with severe stroke, baseline NIHSS (OR=0.808,95%CI:0.677～0.963; P=0.018) independently predicted favorable outcome, while no independent risk factors of HT was found.ConclusionThe influential factors of outcomes in thrombolytic patients with different severity were not completely the same. Mild AIS patients can be benefit from thrombolysis within300minutes; while only in moderate AIS patients, atrial fibrillation was related with hemorrhage transformation after thrombolysis.