Outcome Analysis of tPA Administration in Acute Ischemic Stroke Patients at Nishtar Hospital Multan

Abstract

Objectives: To assess the efficacy (clinical outcome), recovery (disability), and safety of rtPA use through an investigation of patients who were treated at a tertiary hospital for acute ischemic stroke.

Materials & Methods: Retrospective observational study included 115 adults age >18 with an acute ischemic stroke who were treated with intravenous rt-PA at Nishtar Hospital Multan over a year period. Data was obtained from medical record regarding demographics, vascular risk factors, stroke subtype, time to presentation, door-to-needle time, and NIHSS scores at presentation and 90 days after treatment. Data were analyzed using SPSS version 25, ANOVA, and Pearson correlation were used to test for associations between age, stroke severity and outcomes.

Results: Mean age was 55 years and majority of patients suffered from hypertension (62.6%) or diabetes (42.6%). Highest incidence of stroke was as a result of a cardioembolic cause (40%). Majority of patients, 70.4%, still met 10-minute thrombolysis goal, even though they presented late. Majority of patients with 92(80%) showed improvement, recovery and symptoms not worsen during next 72 hours of hospital stay, whilst 14.8% had limited improvement and 5.2% died from stroke. Relationship of age and stroke severity was highly significant at both time of presentation and at 90 days post-stroke (r > 0.89, p < 0.01).

Conclusion: Administration of intravenous rt-PA was linked to a substantial enhancement in neurological function with low death rates even in hospitals with limited resources. Most definitive predictors of success were expedient acute in-hospital therapy (intervention) and adherence to a management protocol.