Clinical Outcomes of Thrombolytic Therapy in Patients with Mild Stroke: A Single-center Experience in a Tertiary Care Institution/Hafif Inmeli Hastalarda Trombolitik Tedavinin Klinik Sonuclari: Ucuncu Basamak Saglik Kurumunda Tek Merkez Deneyimi

• Published in: Türk nöroloji dergisi Vol. 27; no. 3; p. 301
• Main Authors: Karadeli, Hasan Huseyin, Simsekoglu, Ruken
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.09.2021
• Subjects: Drug therapy; Patient outcomes; Stroke (Disease); Thrombolytic therapy; Tissue plasminogen activator; Turkey
• ISSN: 1301-062X; 1309-2545
• DOI: 10.4274/tnd.2021.47560

Objective: Mild stroke is used to describe patients with stroke having a National Institutes of Health Stroke Scale (NIHSS) score of 0-6. However, there is still no clear decision regarding the application of intravenous (iv) recombinant tissue plasminogen activator (iv-tPA) to patients who were admitted with an acute ischemic stroke and were in the mild stroke category. This study aimed to analyze data of patients who applied to our stroke center with an acute mild stroke clinic and received iv-tPA treatment and 3-month follow-up. Materials and Methods: Of 350 patients receiving thrombolytic therapy, 47 (age 69.1[+ or -]14.1, 28 female) patients with mild stroke were included. iv thrombolysis was initiated with a maximum delay of 4.5 h in all patients. Patients had an NIHSS score of less than 6. NIHSS scores immediately before starting thrombolytic therapy and scores 24 h after treatment were recorded. Modified rankin scale scores (mRS) at admission and at 1 and 3 months were recorded. Results: The NIHSS scores of patients who received tPA decreased significantly after the treatment (p=0.001). The mRS scores of the patients at the first and third months were significantly decreased according to the mRS scores when they entered the treatment (p=0.001). Conclusion: This study highlights the efficacy of iv-tPA in patients with acute ischemic stroke and mild symptoms and demonstrates the low-risk profile of this therapy Keywords: Mild stroke, NIHSS, modified rankin scale, thrombolytic treatment, iv-tPA Amac: "Hafif inme" deyimi Ulusal Saglik Enstituleri Inme Olcegi (NIHSS) skoru 0-6 arasinda olan hastalari belirtmek icin kullanilmaktadir. Akut iskemik inme ile basvuran ve hafif inme kategorisinde olan hastalara intravenoz (iv) rekombinant doku plazminojen aktivatorunun (iv-tPA) uygulanmasina iliskin hala net bir karar yoktur. Calismamizda akut hafif inme klinigi ile inme merkezimize basvuran ve iv-tPA tedavisi alan hastalarin verilerini ve uc aylik takiplerini incelemeyi amacladik. Gerec ve Yontem: Trombolitik tedavi alan 350 hastadan 47 (yas; 69,1[+ or -]14,1, 28 kadin) hafif inme hastasi calismaya dahil edildi. Tum hastalara maksimum 4,5 saat gecikmeyle iv tromboliz baslandi. Hastalarin NIHSS skoru 6'dan dusuktu. Trombolitik tedaviye baslamadan hemen onceki NIHSS skorlari ve tedaviden 24 saat sonraki skorlar kaydedildi. Basvuruda, 1. ve 3. aylarda modifiye rankin skoru puanlari (mRS) kaydedildi. Bulgular: Tedavi sonrasi tPA alan hastalarin NIHSS skorlarinin anlamli sekilde azaldigi goruldu (p=0,001). Hastalarin 1. ve 3. ay mRS skorlari tedaviye basladiklarindaki mRS skorlarina gore istatistiksel olarak anlamli azaldigi izlendi (p=0,001). Sonuc: Bu calismadaki veriler hafif inme grubundaki akut iskemik serebrovaskuler olay geciren hastalarda verilen iv-tPA tedavisinin etkinligini, uzun donem engelliligi onemli olcude azalttigini gostermektedir. Anahtar Kelimeler: Hafif inme, NIHSS, modifiye rankin skoru, trombolitik tedavi, iv-tPA