Abstract 2783: Disparities in Ischemic Stroke Presentation and Outcomes Based on Human Development Index of a Nation: A Secondary Analysis of International Stroke Trial

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Yogesh Moradiya ◽  
Sneha Modi
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Human Development ◽  
Human Development Index ◽  
Functional Dependence ◽  
National Development ◽  
Stroke Severity ◽  
Development Index ◽  
Significant Difference ◽  
Stroke Trial

Background and Purpose: Human Development Index (HDI), a comparative composite measure of health, education and standard of living of nations worldwide, is published annually by United Nations Development Programme (UNDP). Our aim was to study the disparities in presentation and outcomes of acute ischemic stroke based on HDIs of nations. Methods: We used the International Stroke Trial (IST) database which was recently made available for public use for novel secondary analyses by independent researchers. IST, one of the largest prospective randomized controlled trials of acute stroke, was conducted in 467 hospitals of 36 countries in years 1991-1996 and included 19435 patients to study the effect of early treatment with aspirin and heparin in acute ischemic stroke. The trial had 99% complete six month follow-up data. We used the internet tool available on UNDP website to find HDIs of participating nations for the year 1995. We calculated National Institute of Health Stroke Scale equivalent stroke severity scale from the clinical findings present on admission. We only included the cases with final diagnosis of acute ischemic stroke and with known HDI (n=17262) in our analysis. We used χ 2 and one-way ANOVA to compare demographic and clinical characteristics between HDI groups. Multivariate logistic regression was used to study numeric HDI value multiplied by 100 as an independent predictor of various outcomes in stroke. Results: There was a significant difference in all the studied stroke characteristics between different HDI groups ( Table 1 ). With each unit increment in HDI by 0.01, odds of in-hospital mortality, complete functional recovery at six months and all-cause mortality at six months decreased by 2.3%, 3.6% and 2.8% respectively and odds of in-hospital recurrent ischemic stroke and functional dependence at six months increased by 4.8% and 2.7% respectively. HDI value could not predict intracranial hemorrhage or major non-cerebral bleeding significantly ( Table 2 ). Conclusions: We identified significant disparities in ischemic stroke presentation and outcomes between countries with different levels of national development. The disparities may have important implications in international health policy making and planning of multinational clinical trials involving acute ischemic stroke.

scholarly journals Pengaruh Keluhan Kesehatan terhadap Indeks Pembangunan Manusia Di Provinsi Jawa Timur

2021 ◽  
Vol 21 (1) ◽  
pp. 239
Author(s):  
Nur Isnaeni Novitasari ◽  
Suharno Suharno ◽  
Arintoko Arintoko
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
Government Expenditure ◽  
Health Sector ◽  
National Development ◽  
Health Complaints ◽  
Development Index ◽  
Health Infrastructure ◽  
Improve Health

The Investments in human capital are the same with improving the quality of human development. The success of national development can be seen from the health aspect in the form of measurement indicator of the Human Development Index. This research analyzes the effect of health complaints, unemployment, poverty and government expenditure on the Human Development Index in East Java Province 2015-2018. This research method uses multiple linear regression with a panel data approach. The results showed that health complaints, unemployment and poverty have a negative and significant effect on the Human Development Index in East Java Province. Meanwhile, government expenditure has a positive and significant effect on the Human Development Index in East Java Province. These findings imply 1) the necessity to improve health infrastructure and government expenditure especially in the health sector, 2) the necessity to increase employment opportunities for reducing poverty and unemployment.

Abstract 202: The NIH Stroke Scale Can Miss Improvement After IV tPA For Acute Ischemic Stroke

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Elisabeth B Marsh ◽  
Erin Lawrence ◽  
Rafael H Llinas
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Post Treatment ◽  
Functional Improvement ◽  
Stroke Severity ◽  
Post Discharge ◽  
Significant Difference ◽  
The Mean ◽  
Iv Tpa

Background and Objective: The National Institute of Health Stroke Scale (NIHSS) is the most commonly used metric to evaluate stroke severity and improvement following intervention. Despite its advantages as a rapid, reproducible screening tool, it may be too insensitive to adequately capture functional improvement following treatment. We evaluated the difference in rate of improvement by previously accepted criteria (change of ≥4 NIHSS points) versus physician documentation in patients receiving IV tissue plasminogen activator (tPA) for acute ischemic stroke. Methods: Prospectively collected data on all patients receiving IV tPA over a 15 month period were retrospectively reviewed. NIHSS 24 hours post-treatment and on discharge were extrapolated based on examination and compared to NIHSS on presentation. NIHSS scores at post-discharge follow-up were also recorded. Two reviewers evaluated the medical record and determined improvement based on physician documentation. Using tests of proportion, ‘significant improvement’ by NIHSS was compared to physician documentation at each time point. Results: Forty-one patients were treated with IV tPA. The mean admission NIHSS was 8.6 and improved to 6.4 24 hours post-tPA. Twenty-nine of 41 patients (79%) were “better” by documentation; however only 11/41 (27%) met NIHSS criteria for improvement (p compared to documentation <0.001). On discharge, 20/41 patients (49%) met NIHSS criteria for improvement; however a significant difference between physician documentation remained (p=0.04). The mean post-discharge follow-up NIHSS score was 2.0. 20/21 patients (95%) were “better” compared to 16/21 (76%) meeting NIHSS criteria (p=0.08). Conclusion: The NIHSS may inadequately capture functional improvement post-treatment, especially in the days immediately following intervention.

scholarly journals Active Cancer and Elevated D-Dimer Are Risk Factors for In-Hospital Ischemic Stroke

2019 ◽  
Vol 9 (3) ◽  
pp. 129-138 ◽  
Author(s):  
Izumi Yamaguchi ◽  
Yasuhisa Kanematsu ◽  
Kenji Shimada ◽  
Masaaki Korai ◽  
Takeshi Miyamoto ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Plasma Levels ◽  
Functional Dependence ◽  
Multivariate Logistic Regression Analysis ◽  
Stroke Onset ◽  
Stroke Severity ◽  
Significant Difference ◽  
Poor Outcomes ◽  
D Dimer ◽  
Active Cancer

Background and Purpose: Little attention has been paid to the pathogenesis of in-hospital stroke, despite poor outcomes and a longer time from stroke onset to treatment. We studied the pathophysiology and biomarkers for detecting patients who progress to in-hospital ischemic stroke (IHS). Methods: Seventy-nine patients with IHS were sequentially recruited in the period 2011–2017. Their characteristics, care, and outcomes were compared with 933 patients who had an out-of-hospital ischemic stroke (OHS) using a prospectively collected database of the Tokushima University Stroke Registry. Results: Active cancer and coronary artery disease were more prevalent in patients with IHS than in those with OHS (53.2 and 27.8% vs. 2.0 and 10.9%, respectively; p < 0.001), the median onset-to-evaluation time was longer (300 vs. 240 min; p = 0.015), and the undetermined etiology was significantly higher (36.7 vs. 2.4%; p < 0.001). Although there was no significant difference in stroke severity at onset between the groups, patients with IHS had higher modified Rankin Scale (mRS) scores (3–6) at discharge (67.1 vs. 50.3%; p = 0.004) and rates of death during hospitalization (16.5 vs. 2.9%; p < 0.001). D-dimer (5.8 vs. 0.8 µg/mL; p < 0.001) and fibrinogen (532 vs. 430 mg/dL; p = 0.014) plasma levels at the time of onset were significantly higher in patients with IHS after propensity score matching. Multivariate logistic regression analysis revealed that active cancer (odds ratio [OR] 2.30; 95% confidence interval [CI] 1.26–4.20), prestroke mRS scores 3–5 (OR 6.78; 95% CI 3.96–11.61), female sex (OR 1.57; 95% CI 1.19–2.08), and age ≥75 years (OR 2.36; 95% CI 1.80–3.08) were associated with poor outcomes. Conclusions: Patients with IHS had poorer outcomes than those with OHS because of a higher prevalence of active cancer and functional dependence before stroke onset. Elevated plasma levels of D-dimer and fibrinogen, especially with active cancer, can help identify patients who are at a higher risk of progression to IHS.

scholarly journals Factors Influencing The First and Second Peak of COVID-19 Global Cases: A Survival Analysis

2021 ◽  
Author(s):  
Yesar Ahmed Oshan ◽  
Begum Zainab ◽  
Dipankar Bandyopadhyay ◽  
Hasinur Rahaman Khan
Keyword(s):  
Population Density ◽  
Human Development ◽  
Human Development Index ◽  
Prevalence Rate ◽  
Median Number ◽  
Cardiovascular Death ◽  
Diabetes Prevalence ◽  
Development Index ◽  
Significant Difference ◽  
Second Peak

Objectives: The number of reported cases continues to increase everyday, since the first case of COVID-19 was detected in Wuhan, China in December 2019. Using the global COVID-19 data of 188 countries extracted from the Our World in Data between January 22, 2020--January 18, 2021, this study attempts to explore the potential determinants of the number of days to reach the first and second peak of COVID-19 cases for all 188 countries. Methods: A semi-parametric Cox proportional hazard (PH) model has been used to explore the covariates that are associated with the number of days to reach the first and second peak of global COVID-19 cases. Results: As of January 18, 2021, the first and second peak were found in 175 and 59 countries, out of 188 countries, respectively. The median number of days to hit the first peak was 60 days for countries which have median age above 40 while the median number of days to hit the second peak was 267 days for countries which have population density above 500 per square kilometer. Countries having population density between 250 and 500 were 2.25 times more likely to experience the first peak of COVID-19 cases (95% CI: 1.15-4.45, P<0.05) than countries which have population density below 25. Countries having population density between 100 and 250 were 67% less likely to get the second peak (95% CI: 0.119-0.908, P<0.05) compared to countries which have population density below 25. Countries having cardiovascular death rates above 350 were 2.94 times more likely to get the first peak (95% CI: 1.59-5.43, P<0.001). In contrast, countries having diabetes prevalence rate 3 to 12 were 85% less likely to experience the second peak of COVID-19 cases (95% CI: 0.036-0.680, P<0.05) than countries which have diabetes prevalence rate below 3. Besides, highly significant difference is found in the Kaplan-Meier plots of the number of days to reach both peaks across different categories of the country's Human Development Index. Conclusions: The number of days to the first peak was considerably small in Asian & European countries but that to the second peak in the countries where diabetes prevalence was very higher. Country's life expectancy had a significant effect on determining the first peak and so was the case for two other variables--the cardiovascular death rate and hospital beds per thousand. A contrast result was found for Human Development Index factor under the second peak. Additionally, it was found that the second peak was more likely to occur in more densely populated countries.

Abstract P208: Racial Differences in Stroke Severity and Outcomes in Female Acute Ischemic Stroke Patients

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Amelia K Boehme ◽  
James E Siegler ◽  
Karen C Albright ◽  
Dominique J Monlezun ◽  
Erica M Jones ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Black Women ◽  
Acute Ischemic Stroke ◽  
Racial Differences ◽  
White Women ◽  
Lower Percentage ◽  
Stroke Severity ◽  
Discharge Disposition ◽  
Significant Difference ◽  
Iv Tpa

Background: Previous research has indicated that women and Blacks have worse outcomes following acute ischemic stroke (AIS). Little research has been done to investigate the influence of race in the presentation and outcome specifically among women with AIS. Methods: AIS patients presenting to two centers in the Stroke Belt (2004-2011) were identified by prospective registries. Men, women who did not identify as Black or White, and in-hospital strokes were excluded. Patient demographics, clinical characteristics, admission National Institutes of Health Stroke Scale (NIHSS) scores, favorable discharge disposition (home or inpatient rehab), time from last seen normal to ED arrival, and functional discharge outcome as measured by the modified Rankin Scale (mRS) were investigated. Patients were divided into 3 groups: (1) not treated with IV t-PA, (2) treated with IV t-PA within 3 hours of symptom onset, and (3) treated with IV t-PA beyond 3 hours. Results: Of the 8763 patients screened, 2217 women met the study criteria (59% White). White women were older (72 vs. 64; p<0.0001), had higher percentage of atrial fibrillation (24% vs. 11%; p<0.0001), lower percentage of diabetes (30% vs. 40%, p<0.0001), lower percentage of hypertension (73% vs. 84%; p<0.0001) and had a higher baseline NIHSS (9 vs. 7; p=0.0045) Administration of tPA was significantly less among Black women (36% Whites vs. 27% Blacks, p<0.0001). White women are at increased odds of receiving tPA treatment (OR=1.43, 95%CI 1.17-1.75, p=0.0005), and remain at increased odds after adjusting for age, baseline NIHSS, time from last seen normal and glucose (OR 1.42, 95% CI 1.11-1.81, p=00044). Despite the significant difference in treatment with IV tPA, White women had increased odds of having a poor functional outcome (OR=1.2, 95% CI 1.02-1.439,p=0.0250) and unfavorable discharge disposition (OR 1.4, 95% CI 1.18-1.67, p=0.0001), but stratifying by tPA treatment groups, race was not found to be predictive of outcome after adjusting for known confounders (i.e., age, glucose, baseline NIHSS, time from last seen normal). Discussion: Unlike data from previous studies, Black women who presented to these two centers with AIS had less severe neurologic deficits on presentation compared to their White counterparts. Despite differences in the proportion of Blacks and Whites treated with IV tPA, race was not significantly associated with outcome. In our study, age and stroke severity_not race_were the primary predictors for poor outcome.

scholarly journals Free Fatty Acids in CSF and Neurological Clinical Scores: Prognostic Value for Stroke Severity in ICU

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sayed Gaber ◽  
Sherine Ibrahim ElGazzar ◽  
Mahmoud Qenawi ◽  
Nora Ismail Mohamed Abbas
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Roc Curve ◽  
Stroke Severity ◽  
Factor Xii ◽  
Cutoff Value ◽  
Positive Correlation ◽  
Increased Risk ◽  
Significant Difference ◽  
Infarction Volume

Introduction. Brain ischemia initiated significant increase in FFAs in animal studies. Accumulation of FFA can lead to liberation of inflammatory byproducts that contribute to neuronal death. Increased risk of systemic thromboembolism was seen in animal models after FFA infusion possibly through activation of factor XII by stearic acids. The clinical studies that examined the relation between stroke in humans and CSF biomarkers are infrequent. Aim of Work. We tried to evaluate the potential role of FFAs in CSF in the diagnosis and the prognosis of ICU patients with AIS while comparing the results to traditional neurological scoring systems. Patients and Methods. Our study included 80 patients who were admitted to ICU with acute ischemic stroke (AIS) within 24 hours of the onset of cerebral infarction. CSF samples were obtained at admission. The FFA levels were measured using the sensitive enzyme-based colorimetric method. The NIHSS, GCS, and mRS were evaluated at admission and at 30 days. Univariate and multivariate analysis were used to evaluate the stroke outcome according to FFA levels in CSF. Results. Worsening of the GCS (<7) at 30 days showed a significant correlation with FFA in CSF. The ROC curve showed a cutoff value of 0.27 nmol/µl, sensitivity of 62.9%, and specificity of 72.2%. There was a significant correlation between FFA in CSF and the mRS >2 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/µl, specificity of 69.2%, and sensitivity of 59.7%. There was a significant correlation between FFA in CSF and the NIHSS ≥ 16 at 30 days. The ROC curve showed a cutoff value of 0.27 nmol/µl, specificity of 72.2%, and sensitivity of 62.9%. Our study subdivided patients according to infarction volume and compared the 2 subgroups with FFA in CSF. We found a significant difference between 2 subgroups. FFA levels showed a positive correlation with infarction volume ≥145 ml. The ROC curve showed a cutoff value of 0.25 nmol/µl, sensitivity of 76.9%, and specificity of 71.4%. Our study showed that FFA in CSF was a significant predictor of all-cause mortality (0.37 + 0.26, P value 0.007). The ROC curve showed a cutoff value of 0.27, specificity of 72.2%, and sensitivity of 62.9%. There was a positive correlation between FFA in CSF and neurological causes of mortality (0.48 + 0.38, P value 0.037). The ROC curve showed a cutoff value of 0.37 nmol/µl, specificity of 76.1%, and sensitivity of 61.5%. Conclusion. FFA in CSF may serve as an independent prognostic biomarker for assessing the prognosis of acute ischemic stroke and the clinical outcome. It might be a useful biomarker for early detection of high-risk patients for poor outcome and hence more aggressive treatment.

scholarly journals Blood Pressure and Heat Shock Protein 70 Levels Related to Acute Ischemic Stroke Severity

2020 ◽  
Vol 2 (2) ◽  
pp. 49-55
Author(s):  
Syarif Indra ◽  
Umul Khair ◽  
Yulia Trisna
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Heat Shock ◽  
Heat Shock Protein ◽  
Acute Ischemic Stroke ◽  
P Value ◽  
Stroke Severity ◽  
Hsp 70 ◽  
Cross Sectional ◽  
Significant Difference

Introduction: Hypertension is a risk factor of ischemic stroke, the prevalence of ischemic stroke in Indonesia is 34.1%. Heat Shock Protein (HSP) 70 increases in hypertension and acute phase of ischemic stroke. To determine differences of blood pressure (BP) and HSP 70 levels, related to the acute ischemic stroke severity. Methods: This was a cross-sectional study that was carried out in the Neurological Ward of Dr.M.Djamil Hospital and National Stroke Hospital, from May to September 2019. Inclusion criteria were obtained consecutively. BP was measured with a sphygmomanometer, stroke severity was measured by NIHSS, and HSP 70 levels was analyzed by the ELISA. Computerized statistical analyzes were performed using SPSS software version 23.0 for windows. The result was statistically significant if the p-value < 0.05. Results: There were 40 samples consisted of 26 (65%) male, mean age 59.78 years. The systolic BP ranging from 130 to 190 mmHg (median 160), the diastolic BP ranging from 70 to 100 mmHg (median 90), the HSP 70 levels ranging from 2.50 to 19.56 ng/mL (median 2.72). There were 18 patients with mild stroke and 22 patients with moderate stroke. There was no significant difference between systolic blood pressure (SBP), diastolic blood pressure (DBP), and severity of stroke (p=0,369; p=0,221, respectively). There was no significant difference between HSP 70 levels and the severity of stroke (p=0,312). There was no relation between the degree of BP and HSP 70 levels. Conclusion: There were no significant differences of SBP, DBP, and HSP 70 with the acute ischemic stroke severity.

scholarly journals Measures of human development: a narrative

2019 ◽  
Vol 6 (2) ◽  
pp. 889 ◽  
Author(s):  
Ramprasad Vasthare ◽  
Shriya Dhaundiyal ◽  
Sunaina Puri
Keyword(s):  
Human Development ◽  
Human Development Index ◽  
National Development ◽  
Influential Factors ◽  
Women Empowerment ◽  
Direct Function ◽  
Important Indicator ◽  
Development Index ◽  
The Subject ◽  
The Impact

Human development is a direct function of human capability, understood through the different facets of the human development index. The impact of gender inequality, women empowerment, environmental and socioeconomic sustainability has also been described in this review. It brings forth and reinforces that national development is an assessment of not only per capita income but by other influential factors which affect development comprehensively, such as educational achievements and health. A thorough primary screening was done for articles on human development index using the data bases of PubMed, Scopus and Google Scholar using the key words human development, United Nations, measures, indicators and index, followed by a secondary screening, with due concern to avoid overlap of information. The articles were categorized based on the subject of Human Development with due prioritization. Human development index has evolved periodically taking into consideration the developments, limitations and criticisms. It has become an important indicator of human progress and serves as a guide to state, societal, community and individual developments. India currently holds a rank of 130 denoting medium human development.

scholarly journals Baseline characteristics of the 3096 patients recruited into the ‘Triple Antiplatelets for Reducing Dependency after Ischemic Stroke’ trial

2016 ◽  
Vol 12 (5) ◽  
pp. 524-538 ◽  
Author(s):  
Philip MW Bath ◽  
Jason P Appleton ◽  
Maia Beridze ◽  
Hanne Christensen ◽  
Robert A Dineen ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Transient Ischemic Attack ◽  
Stroke Severity ◽  
Vascular Events ◽  
Risk Of Recurrence ◽  
Triple Antiplatelet Therapy ◽  
Ischemic Attack ◽  
Stroke Trial

Background The risk of recurrence following ischemic stroke or transient ischemic attack is highest immediately after the event. Antiplatelet agents are effective in reducing the risk of recurrence and two agents are superior to one in the early phase after ictus. Design The triple antiplatelets for reducing dependency after ischemic stroke trial was an international multicenter prospective randomized open-label blinded-endpoint trial that assessed the safety and efficacy of short-term intensive antiplatelet therapy with three agents (combined aspirin, clopidogrel and dipyridamole) as compared with guideline treatment in acute ischemic stroke or transient ischemic attack. The primary outcome was stroke recurrence and its severity, measured using the modified Rankin Scale at 90 days. Secondary outcomes included recurrent vascular events, functional measures (cognition, disability, mood, quality of life), and safety (bleeding, death, serious adverse events). Data are number (%) or mean (standard deviation, SD). Results Recruitment ran from April 2009 to March 2016; 3096 patients were recruited from 106 sites in four countries (Denmark 1.6%, Georgia 2.7%, New Zealand 0.2%, UK 95.4%). Randomization characteristics included: age 69.0 (10.1) years; male 1945 (62.8%); time onset to randomization 29.4 (11.9) h; stroke severity (National Institutes for Health Stroke Scale) 2.8 (3.6); blood pressure 143.5 (18.2)/79.5 (11.4) mmHg; IS 2143 (69.2%), transient ischemic attack 953 (30.8%). Conclusion Triple antiplatelets for reducing dependency after ischemic stroke was a large trial of intensive/triple antiplatelet therapy in acute ischemic stroke and transient ischemic attack, and included participants from four predominantly Caucasian countries who were representative of patients in many western stroke services.

Abstract T P298: Impact of Accurate Weight Based Dosing of IV tPA in Acute Ischemic Stroke Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Vishal B Jani ◽  
Sopan Lahewala ◽  
Shilpkumar Arora ◽  
Erin Shell ◽  
Anmar Razak ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Statistical Significance ◽  
Categorical Variables ◽  
Stroke Severity ◽  
Fisher Exact Test ◽  
Weight Estimation ◽  
Stroke Patients ◽  
Significant Difference ◽  
Iv Tpa

Background: Accurate weight-based dosing is essential for efficacy and safety of thrombolysis in acute ischemic stroke (AIS). Stroke patients may be unable to communicate correct body weight (BW). Dosing may be estimated which can lead to error. Objective: To assess accuracy of weight estimation and the effect of weight and dosing discrepancy on outcome of patients with AIS Methods: 94 patients receiving IV tpa for AIS in a CSC registry between Feb, 2013 and Jul, 2014 were reviewed. All were given estimated weight based tPA- per patient input or agreement of 2 providers in ER. Accurate weights were obtained and recorded later. Actual weight was used to calculate the ideal TPA doses and compared to the weights and doses used. The cohort was separated into two groups based on weight discrepancy to those 10 kg (non forgiven) discrepancy. Rate of hemorrhage, NIHSS and hospice/mortality were assessed. Difference between categorical variables was tested using the chi-square and Fisher’ Exact Test. Differences between continuous variables were tested using Wilcoxon Rank Sum test and presented with median and IQ range. Results: 86.1% (forgiven cohort) were given the optimal tPA dose despite estimation. There was a significant difference in stroke severity based on admission NIHSS between the cohorts (33.3% in forgiven vs. 69.2% non-forgiven. P=0.04). Stroke severity based on discharge NIHSS did not reach statistical significance (mild: 71.8% vs 63.6%, moderate: 16.9% vs 9.1% and severe: 11.3% vs 27.3%, p = 0.32). 30 days modified Rankin Scale (mRS) was available for 52 pts without any significant difference (good outcome 44.4% vs 57.1%, poor outcome 35.6 % vs 28.6 %, p = 0.82). Statistically non significance toward higher rate of hemorrhagic conversion (6.4% vs 7.7%, p = 0.41), and higher mortality in non-forgiven group (7.41% vs 15.38%, p= 0.33). Conclusion: Accurate BW measurement prior tPA still remains challenging. In this study, weight estimation by 2 providers is fairly accurate. 14 % of the patients with discrepancy of > 10 kg had higher rate of mortality and hemorrhage although this was not statistically significant. Further studies with larger sample sizes are needed to examine the safety of weight estimation in AIS patients who receive IV tpa

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