Intravenous thrombolysis in patients with acute ischemic stroke: institutional retrospective cohort study

Abstract

Ischemic Stroke represents a major medical emergency, ranking second place after ischemic heart disease in the structure of mortality and disability of the population at national and global level. This article represent a retrospective study. It were selected and analized a total of 126 medical records of patients diagnosed with acute ischemic stroke undergoing intravenous thrombolysis. These patients were admitted to the Diomid Gherman Institute of Neurology and Neurosurgery between 2019 and 2023. The study included 61 men (48.41%) and 65 women (51.59%), with a mean age of 69±8.5 years. The identified risk factors in these patients were arterial hypertension, diabetes mellitus, obesity, and cardiac rhythm disorders (atrial fibrillation).Patients who arrived at the Diomid Gherman Institute of Neurology and Neurosurgery within 4.5 hours of symptom onset, displayed specific clinical symptoms, and had no signs of intracerebral hemorrhage or ischemia on cerebral CT were included in the study and received revascularization treatment with rtPA. The NIHSS score at admission was 14 points, which decreased to 10 points after thrombolysis. An improvement in the NIHSS score was observed in 70.62% of patients, with an average reduction of 10 points (minimum 3 points - maximum 17 points) after rtPA administration. Among patients whose NIHSS score remained the same or worsened (a total of 44 patients), 30 deaths (24.59%) were recorded, predominantly in patients with severe comorbidities or an initial NIHSS score >17 points. The implementation of intravenous thrombolysis in patients with acute ischemic stroke proved effective, contributing to the reduction ofneurological deficit severity, and increasing recovery rates. However, the results of this study highlight the importance of early diagnosis of stroke signs and symptoms and the need to optimize the emergency system to facilitate faster access to treatment.