Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia
INTRODUCTION Intravenous (IV) thrombolysis with alteplase (rt-PA) is effective in ischaemic stroke. The primary objective was to evaluate predictors of functional outcome in acute ischaemic stroke (AIS) patients treated with IV rt-PA. The secondary objective was to assess the outcome with the modifi...
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Stamford Publishing Pte Ltd / Singapore Medical Association
2019
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| author | Tai, Mei Ling Sharon Goh, Khean Jin Abd Kadir, Khairul Azmi Zakaria, Mohd Idzwan Yap, Jun Fai Tan, Kay Sin |
| author_facet | Tai, Mei Ling Sharon Goh, Khean Jin Abd Kadir, Khairul Azmi Zakaria, Mohd Idzwan Yap, Jun Fai Tan, Kay Sin |
| author_sort | Tai, Mei Ling Sharon |
| collection | UM |
| description | INTRODUCTION Intravenous (IV) thrombolysis with alteplase (rt-PA) is effective in ischaemic stroke. The primary objective was to evaluate predictors of functional outcome in acute ischaemic stroke (AIS) patients treated with IV rt-PA. The secondary objective was to assess the outcome with the modified Rankin scale (mRS). We also examined the predictive value of the Totaled Health Risks in Vascular Events (THRIVE) score. METHODS AIS patients treated with IV rt-PA from February 2012 to August 2016 were recruited. Demographic data, National Institutes of Health Stroke Scale (NIHSS) scores, timing and neuroradiological findings were recorded. Patients received a dose of 0.9 mg/kg IV rt-PA within 4.5 hours of symptom onset. mRS score was evaluated at discharge and three months, and good and poor clinical outcomes were defined as scores of 0–2 and 3–6, respectively. Baseline THRIVE scores were assessed. RESULTS 36 patients received IV rt-PA. 20 (55.6%) patients had an mRS score of 0–2 at three months. Based on THRIVE score, 86.1% had a good or moderately good prognosis. On univariate analysis, poor outcome was associated with NIHSS score before rt-PA (p = 0.03), THRIVE score (p = 0.02), stroke subtype (p = 0.049) and diabetes mellitus (DM; p = 0.06). Multiple logistic regression showed that outcome was significantly associated with NIHSS score before rt-PA (p = 0.032) and DM (p = 0.010). CONCLUSION Our newly developed Malaysian IV rt-PA service is safe, with similar outcomes to the published literature. Functional outcome after thrombolysis was associated with baseline NIHSS score and DM. © 2019, Singapore Medical Association. All rights reserved. |
| first_indexed | 2024-03-06T05:59:57Z |
| format | Article |
| id | um.eprints-23470 |
| institution | Universiti Malaya |
| last_indexed | 2024-03-06T05:59:57Z |
| publishDate | 2019 |
| publisher | Stamford Publishing Pte Ltd / Singapore Medical Association |
| record_format | dspace |
| spelling | um.eprints-234702020-01-20T01:17:35Z http://eprints.um.edu.my/23470/ Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia Tai, Mei Ling Sharon Goh, Khean Jin Abd Kadir, Khairul Azmi Zakaria, Mohd Idzwan Yap, Jun Fai Tan, Kay Sin R Medicine INTRODUCTION Intravenous (IV) thrombolysis with alteplase (rt-PA) is effective in ischaemic stroke. The primary objective was to evaluate predictors of functional outcome in acute ischaemic stroke (AIS) patients treated with IV rt-PA. The secondary objective was to assess the outcome with the modified Rankin scale (mRS). We also examined the predictive value of the Totaled Health Risks in Vascular Events (THRIVE) score. METHODS AIS patients treated with IV rt-PA from February 2012 to August 2016 were recruited. Demographic data, National Institutes of Health Stroke Scale (NIHSS) scores, timing and neuroradiological findings were recorded. Patients received a dose of 0.9 mg/kg IV rt-PA within 4.5 hours of symptom onset. mRS score was evaluated at discharge and three months, and good and poor clinical outcomes were defined as scores of 0–2 and 3–6, respectively. Baseline THRIVE scores were assessed. RESULTS 36 patients received IV rt-PA. 20 (55.6%) patients had an mRS score of 0–2 at three months. Based on THRIVE score, 86.1% had a good or moderately good prognosis. On univariate analysis, poor outcome was associated with NIHSS score before rt-PA (p = 0.03), THRIVE score (p = 0.02), stroke subtype (p = 0.049) and diabetes mellitus (DM; p = 0.06). Multiple logistic regression showed that outcome was significantly associated with NIHSS score before rt-PA (p = 0.032) and DM (p = 0.010). CONCLUSION Our newly developed Malaysian IV rt-PA service is safe, with similar outcomes to the published literature. Functional outcome after thrombolysis was associated with baseline NIHSS score and DM. © 2019, Singapore Medical Association. All rights reserved. Stamford Publishing Pte Ltd / Singapore Medical Association 2019 Article PeerReviewed Tai, Mei Ling Sharon and Goh, Khean Jin and Abd Kadir, Khairul Azmi and Zakaria, Mohd Idzwan and Yap, Jun Fai and Tan, Kay Sin (2019) Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia. Singapore Medical Journal, 60 (5). pp. 236-240. ISSN 0037-5675, DOI https://doi.org/10.11622/smedj.2018150 <https://doi.org/10.11622/smedj.2018150>. https://doi.org/10.11622/smedj.2018150 doi:10.11622/smedj.2018150 |
| spellingShingle | R Medicine Tai, Mei Ling Sharon Goh, Khean Jin Abd Kadir, Khairul Azmi Zakaria, Mohd Idzwan Yap, Jun Fai Tan, Kay Sin Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia |
| title | Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia |
| title_full | Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia |
| title_fullStr | Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia |
| title_full_unstemmed | Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia |
| title_short | Predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in Malaysia |
| title_sort | predictors of functional outcome in patients with stroke thrombolysis in a tertiary hospital in malaysia |
| topic | R Medicine |
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