Clinical Outcome of Thrombolytic Therapy for Acute Ischemic Stroke at Somdejprabuddhalertla Hospital

Abstract

Objectives: The purpose of this study was to determine clinical outcome and complications of thrombolytic therapy for acute ischemic stroke at Somdejprabuddhalertla Hospital.

Methods: Retrospective study of thrombolytic therapy with recombinant tissue plasminogen activator (rt-PA) in acute ischemic stroke patients within 4.5 hours of onset in Somdejprabuddhalertla Hospital during December 2013 to February 2015. Primary outcome was clinical response after thrombolytic therapy, evaluated in National Institutes of Health Stroke Scale (NIHSS) at 12, 24 hours and modified Rankin Scale (mRS) at day 1, day 30 after treatment. Secondary outcome in the aspects of bleeding complication especially intracerebral hemorrhage and mortality.

Result: A total of twenty two patients had 10 females (45.45%) and mean age of 66.41±13.32. Mean time from onset to hospital was 62.25 minutes and door to needle mean time was 120.40 minutes. Outcomes of treatment with thrombolytic therapy compare by used of NIHSS at onset with 12 and 24 hours. Mean NIHSS at onset 13.41±7.12 compared with at 12 hours 9.68±10.20 (p = 0.013). Compare with at 24 hours 8.64±8.97 (p = 0.004) and at 12 and 24 hours, there were 10 patients (45.45%) have good outcome defined as NIHSS 0-1 and mRS 0-1. At 3 month there were 10 patients (45.45%) had no significant disability by mRS. Bleeding complication, there were 3 patient (13.63%) had bleeding complication, one was intracerebral hemorrhage (4.54%). Mortality rate in our study is 1 patient (4.54%).

Conclusion: Thrombolytic therapy with rt-PA for acute ischemic stroke at Somdejprabuddhalertla Hospital had been implemented successfully and had a good outcome to reduced neurological deficit and disability.