Summary
BACKGROUND: Intravenous thrombolysis (IVT) for acute ischaemic stroke is safe and effective in routine clinical use. We aimed to identify baseline predictors of excellent outcome after 3 months, defined by a modified Rankin Scale score ≤1. METHOD: We analysed data entered in the Austrian Stroke Unit Registry up to February 28th 2007. RESULTS: Eight hundred and twelve patients received IVT after admission to a stroke unit within 3 hours of stroke onset. Of 386 patients with complete follow-up at 3 months, 201 (52.1%) had an excellent outcome. Multivariate regression analyses identified age (odds ratio (OR) 0.96; 95% confidence intervals (CI) 0.94–0.98; p < 0.0005) and admission score on the National Institute of Health Stroke Scale (NIHSS; OR 0.87; 95% CI 0.84–0.91; p < 0.0005) to be independent predictors of excellent outcome. CONCLUSIONS: Age and admission NIHSS score were found to powerfully predict outcome after IVT. However, results may be compromised by the loss to follow-up bias.
Zusammenfassung
GRUNDLAGEN: Die intravenöse Thrombolyse (IVT) gilt in der klinischen Routine als sichere und effektive Therapie des akuten ischämischen Schlaganfalls. Unser Ziel war die Identifikation von Baseline-Prädiktoren eines exzellenten 3-Monats-Outcomes (modified Rankin Scale Score ≤1). METHODIK: Wir analysierten Daten des Österreichischen Stroke Unit Registers (Eingaben bis 28. Februar 2007). ERGEBNISSE: Von 812 Patienten, die innerhalb 3 Stunden nach Einsetzen der Schlaganfallsymptome auf eine Stroke Unit aufgenommen und in der Folge mit IVT behandelt wurden, lag bei 386 ein 3-Monats-follow-up vor. 201 der 386 (52,1 %) Patienten hatten dabei ein exzellentes Outcome. Multivariate Regressionsanalysen identifizierten Alter (odds ratio [OR] 0,96; 95 % Konfidenzintervalle [CI] 0,94–0,98; p < 0,0005) und initialen National Institute of Health Stroke Scale (NIHSS) Score (OR 0,87; 95 % CI 0,84–0,91; p < 0,0005) als unabhängige Prädiktoren eines exzellenten 3-Monats-Outcomes. SCHLUSSFOLGERUNGEN: Alter und initialer NIHSS-Score sind starke Prädiktoren für das Outcome nach Thrombolyse. Unsere Ergebnisse werden durch den hohen Verlust an Follow-up-Daten geschmälert.
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Topakian, R., Haring, HP. & Aichner, F. Prädiktoren des Schlaganfall-Outcome nach intravenöser Thrombolyse – Daten des Österreichischen Stroke Unit Registers. Wien Med Wochenschr 158, 429–434 (2008). https://doi.org/10.1007/s10354-008-0566-3
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DOI: https://doi.org/10.1007/s10354-008-0566-3