Gender and thrombolysis therapy in acute ischemic stroke patients with incidence of obesity

2019 ◽  
Vol 40 (9) ◽  
pp. 1829-1839 ◽  
Author(s):  
Brice Blum ◽  
Alexandria Penwell ◽  
Leah Wormack ◽  
Brittany Walker ◽  
Shyyon Lari ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
Thrombolysis Therapy

Prognostic models for ambulatory recovery functions in acute ischemic stroke patients with thrombolysis therapy

2018 ◽  
Author(s):  
Matthew Scalise ◽  
Jordan Gainey ◽  
Benjamin Bailes ◽  
Leanne Brecthtel ◽  
Zachary Conn ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Prognostic Models ◽  
Broca's Aphasia ◽  
Stroke Patients ◽  
Motor Speech ◽  
Stroke Registry ◽  
Broca’S Aphasia ◽  
Thrombolysis Therapy

Abstract Background. The purpose of this study was to develop models to predict the recovery of ambulatory functions taking into account the capability of the motor system to functionally reorganize in response to thrombolysis therapy. Methods. We predicted ambulatory functions recovery using retrospective data from a stroke registry of acute ischemic stroke patients who received thrombolysis therapy. Multivariate regression was used to construct the models. Multicollinearity and significant interactions were examined using variance inflation factors, while a Cox & Snell classification were applied to check the fitness of each model. Results. The models correctly predicted clinical variables that were associated with an improvement or non-improvement in functional ambulatory outcome. Broca’s aphasia (OR = 2.270, P = 0.002, CI =1.34-3.83) was associated with improved functional outcome at discharge, while patients aged 80 years or older (OR = 0.942, P = <0.001, CI =0.92-0.96), patients with congestive heart failure (OR = 0.496, P = 0.040, CI = 0.25-0.97), higher NIHSS (OR=0.876, P = 0.001, CI = 0.80-0.95), taking antihypertensive medication (OR = 0.436, P = 0.023, CI = 0.21-0.89) were not associated with improved ambulatory functional outcome with thrombolysis. The discriminating ability for the model was 74.2% for the total population, 71.7% for the rtPA group, and 72.2% for the no-rtPA group indicating strong performance. Conclusion. Prognostic models that can predict improved functional ambulatory outcome in thrombolysis therapy can be beneficial in the care of stroke patients. Our models predicted improved functional recovery of Broca’s aphasia after thrombolysis therapy, suggesting a future potential to evaluate motor speech area after stroke.

scholarly journals Effect of antihypertensive medications on thrombolysis therapy and outcomes in acute ischemic stroke patients

2019 ◽  
Vol 21 (2) ◽  
pp. 271-279 ◽  
Author(s):  
Tyler Fleming ◽  
Brice Blum ◽  
Benjamin Averkamp ◽  
James Sullivan ◽  
Thomas Nathaniel
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
Antihypertensive Medications ◽  
Thrombolysis Therapy

Direct access to a hospital offering intravenous thrombolysis therapy improves functional outcome of acute ischemic stroke patients

2014 ◽  
Vol 21 (8) ◽  
pp. 1428-1432 ◽  
Author(s):  
Dae-Hyun Kim ◽  
Jae-Kwan Cha ◽  
Hyun-Seok Park ◽  
Jae-Hyung Choi ◽  
Myung-Jin Kang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Intravenous Thrombolysis ◽  
Direct Access ◽  
Stroke Patients ◽  
Thrombolysis Therapy

scholarly journals Role of Span-75 in Determining Prognosis of Non-Thrombolysis Acute Ischemic Stroke Patients

Medicinus ◽  
2020 ◽  
Vol 7 (7) ◽  
pp. 209
Author(s):  
Anyeliria Sutanto ◽  
Astra Dea Simanungkalit ◽  
Evelyn Yunita ◽  
Anastasya Chandra ◽  
Aristo Pangestu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients ◽  
Degree Of Disability ◽  
Stroke Disability ◽  
And Gender ◽  
Severe Degree ◽  
Time Of Admission ◽  
Thrombolysis Therapy

<div class="WordSection1"><p><strong>Introduction: </strong>The SPAN-75 index is a modification of the SPAN-100 index as a prognostic tool in acute ischemic stroke patients. Previous studies were using SPAN index in cases of ischemic stroke patients treated with rTPA and in cases of intracerebral hemorrhage.</p><p><strong>Aim: </strong>To determine the role of the SPAN-75 index as a prognostic scoring in patients with acute ischemic stroke who did not get thrombolysis therapy.</p><p><strong>Method: </strong>The subjects were acute ischemic stroke patients at Siloam Hospitals Lippo Village who were not treated with thrombolysis therapy and had no disability before stroke onset during January to April 2019. Subjects were classified into a positive and negative of SPAN-75 index group. Disability due to stroke was assessed with Modified Rankin Score (mRS) at the time of admission and discharged from the hospital. This prospective study was analyzed by the Kruskal-Wallis test.</p><p><strong>Result</strong>: Forty subjects (average age of 57 years old) consisted of 31 negative and 9 positive of SPAN-75. Based on the Kruskal-Wallis test, the SPAN-75 index was positively associated with a more severe degree of stroke disability at the time of admission (p = 0.002), but not related to the change in the degree of disability when the patient was discharged from the hospital (p = 0.807). Age (p = 0.445) and gender (p = 0.578) had no significant relationship with the degree of disability of acute ischemic stroke.</p><p><strong>Conclusion: </strong>The SPAN-75 index is related to the degree of disability of acute stroke patients at the time of admission.</p></div>

scholarly journals In acute ischemic stroke patients with smoking incidence, are more women than men more likely to be included or excluded from thrombolysis therapy?

2020 ◽  
Vol 16 ◽  
pp. 174550652092276
Author(s):  
Oluyemi R Rotimi ◽  
Iretioluwa F Ajani ◽  
Alexandria Penwell ◽  
Shyyon Lari ◽  
Brittany Walker ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Recombinant Tissue Plasminogen Activator ◽  
Stroke Patients ◽  
Initial Examination ◽  
Tissue Plasminogen ◽  
History Of ◽  
Thrombolysis Therapy

Background: Clinical factors associated with exclusion from recombinant tissue plasminogen activator in both men and women are not completely understood. The aim of this study is to determine whether there is a gender difference in clinical risk factors that excluded ischemic stroke patients with a history of smoking from recombinant tissue plasminogen activator. Methods: Retrospective data from a stroke registry were analyzed, and multivariable linear regression models were used to determine gender differences. Logistic regression models determined exclusion clinical risk factors for thrombolysis in male and female acute ischemic stroke patients with a history of smoking, while sequentially adjusting for sociodemographic, clinical, and stroke-related variables. The Kaplan–Meier survival analysis was used to determine the exclusion probabilities of men and women with a history of smoking within the stroke population. Results: Of the 1,446 acute ischemic stroke patients eligible for recombinant tissue plasminogen activator, 379 patients with a history of smoking were examined, of which 181 received recombinant tissue plasminogen activator while 198 were excluded from receiving recombinant tissue plasminogen activator. Of the 198 patients, 75 females and 123 males were excluded from receiving recombinant tissue plasminogen activator. After multivariable adjustment for age, National Institutes of Health scores, and stroke-related factors, females who present with weakness/paresis on initial examination (OR = 0.117, 95% CI, 0.025–0.548) and men who present with a history of previous transient ischemic attack (OR = 0.169, 95% CI, 0.044–0.655), antiplatelet medication use (OR = 0.456, 95% CI, 0.230–0.906), and weakness/paresis on initial examination (OR = 0.171, 95% CI, 0.056–0.521) were less likely to be excluded from recombinant tissue plasminogen activator (thrombolysis therapy). Conclusions: In an ischemic stroke population with a history of smoking, female smokers are more likely to be excluded from thrombolysis therapy in comparison to men, even after adjustment for confounding variables.

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