Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Early neurological deterioration in acute ischemic stroke patients after intravenous thrombolysis with alteplase predicts poor 3-month functional prognosis - data from the Thrombolysis Implementation and Monitor of Acute Ischemic Stroke in China (TIMS-China)
First author：Fengli Che
Corresponding author：Xingquan Zhao,Yunjun Wang
essential_information
- Person in charge：Fengli Che
- Data Sources： TIMS-CHINA
- Number of papers：TIMS-CHINA20210116
- Published time：2022-06-07
2022-06-07
Published articles
Journal：BMC Neurology
Publication type: Original Contributions
IF(IF): 2.903
PMID: 35672740 Link To Pubmed Full text Download
Background And Purpose
Intravenous thrombolysis with recombinant tissue-type plasminogen activator (rt-PA) within 4.5 hours of acute ischaemic stroke has been confirmed as the most effective treatment protocol for acute ischemic stroke. However, some patients still can not benefit from such treatment because of early neurological deterioration (END). We aim to investigate the risk factors associated with END in acute ischemic stroke patients after intravenous thrombolysis with alteplase and the relationship between END and 3-month poor functional outcome.
Method
Patients who accepted intravenous recombinant rt-PA were enrolled continuously. END was defned as an increase in National Institute of Health Stroke (NIHSS) score≥4 points or death within 24hours after intravenous thrombolysis. The modifed Rankin Scale (mRS) score was recorded to evaluate the functional outcome of stroke, and the poor 3-month prognosis was defned as an mRS score≥of 3. Univariate and multivariate analyses were used to analyze the risk factors of END. The relation between END and 3-month functional outcome was analyzed by multivariate logistic regression analysis.
Conclusion
The initial serum glucose level might be an independent risk factor of END, and END might predict a poor 3-month prognosis.
Main results
A total of 1107 patients (mean age, 63.42±11.33 years; 673 males) were included in the fnal analysis, and 81(7.32%) patients had END. In multivariate analysis, the serum glucose level was signifcantly associated with END; the odds ratio was 1.10 (95% CI 1.03 to 1.18, p=0.004). The multivariate logistic analysis showed END has a notable association with the poor 3-month functional recovery even after adjusting for confounding factors; the adjusted OR was 8.25 (95% CI 3.77 to 18.03, p<0.0001).