Retrospective analysis of the data of patients who were admitted to the secondary care hospital with the diagnosis of acute ischemic stroke and received intravenous thrombolytic therapy.

Abstract

Objective: Acute ischemic stroke is a cause of long-term disability in developing countries. Intravenous tissue plasminogen activator (iv-tPA) is the most effective medical treatment shown to provide clinical improvement. Our aim in this study is to investigate the relationship between the clinical data of our patients treated with iv-tPA and the changes in serum inflammatory parameters; and to help increase the prevalence of treatment in secondary hospitals.

Methods: Forty-nine patients diagnosed as acute ischemic stroke and treated with iv-tPA at Siirt Research and Training Hospital between April 2019 and June 2020 were included in this study. Demographic and clinical findings, serum platelet/lymphocyte ratio (PLR), neutrophyle/ lymphocyte ratio (NLR) and CRP/albumin ratio (CAR), radiological data, symptom-door-needle times, trombectomy, complication and mortality rates, pre and post treatment 7^th day of National Institutes of Health Stroke Scale Scores (NIHSS) and first and third-month of modified Rankin Scale (mRS) scores, and prognosis were evaluated.

Results: The mean age was 71.2±13.7 years. Female-to-male ratio was almost 1. Decreases in the post-treatment NIHSS scores were statistically significant compared with the baseline (p<0.001). First month's mRS score was statistically decreased in the third month follow up significantly (p=0.002). There were significant differences between the baseline and post-treatment laboratory values. Significant increases in the values of NLR, and CAR were detected (p=0.012, p=0.009). Correlation analysis revealed significant positive correlations between post-treatment NIHSS and CAR, PLR, NLR. PLR and NLR were significantly correlated with the third month mRS score (p<0.001, p=0.011). Symptom-to-door time, door-to-needle time, and symptom-to-needle time were not correlated with the NIHSS and mRS scores.

Conclusion: It would be beneficial to treat the patients with iv-tPA in secondary-staged hospitals and should be widespread. Rapid treatment is sufficient and can reduce complications and poor outcomes. Elevated levels of NLR, PLR, and CAR predict modest consequences.