scholarly journals Advanced Age and Higher National Institutes of Health Stroke Scale Score as Predictors of Poor Outcome in Ischemic Stroke Patients Treated with Alteplase: A Study from a Tertiary Care Centre in Rural North-west India

2017 ◽  
Vol 08 (02) ◽  
pp. 236-240 ◽  
Author(s):  
Amit Bhardwaj ◽  
Girish Sharma ◽  
Sunil Kumar Raina ◽  
Ashish Sharma ◽  
Monica Angra
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Tertiary Care ◽  
National Institutes Of Health ◽  
Stroke Patients ◽  
Nihss Score ◽  
Good Outcome ◽  
Poor Outcome ◽  
The Poor

ABSTRACT Introduction: Thrombolytic therapy in acute ischemic stroke has been approved for treatment of acute stroke for past two decades. However, identification of predictors of poor outcome after the intravenous (IV) alteplase therapy in acute stroke patients is a matter of research. The present study was conducted with the aim of identifying poor prognostic factors in patients of acute ischemic stroke patients. Methods: The data of 31 acute stroke patients treated with alteplase were gathered to identify the factors that were independent predictors of the poor outcome. Outcome was dichotomized using modified Rankin scale (mRS) score and National Institutes of Health Stroke Scale (NIHSS) score at 3 months after treatment into good outcome mRS - 0–2 and poor outcome mRS - 3–6. Predictors of poor outcome were analyzed. Results: Good outcome (mRS – score 0–2) was seen in 15 (48.4%) patients with median age of (60) and poor outcome (mRS – score 3–6) was seen in 16 (51.6%) patients median age of 75 years, which was statistically significant with the P = 0.002. The presence of risk factors such as hypertension, diabetes, dyslipidemia, smoking, alcohol intake, history of stroke, coronary artery disease, and rheumatic heart disease among the two groups did not seem influence outcome. The severity of stroke as assessed by NIHSS score at the time of presentation was significantly higher among the patients with poor outcome, with P = 0.01. Conclusion: Advance age and higher NIHSS score at the time of onset of stroke and are the independent predictors of the poor outcome after thrombolysis with IV alteplase treatment in acute ischemic stroke patients.

Abstract 10: Predictors of Poor Outcome in Acute Ischemic Stroke Patients after Successful Recanalization

2014 ◽  
Vol 7 (suppl_1) ◽  
Author(s):  
Amy K Starosciak ◽  
Italo Linfante ◽  
Gail Walker ◽  
Osama O Zaidat ◽  
Alicia C Castonguay ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cerebral Infarction ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Predictive Power ◽  
Rescue Therapy ◽  
Univariate Analysis ◽  
Stroke Patients ◽  
Good Outcome ◽  
Poor Outcome

Background: Recanalization of the occluded artery is a powerful predictor of good outcome in acute ischemic stroke secondary to large artery occlusions. Mechanical thrombectomy with stent-trievers results in higher recanalization rates and better outcomes compared to previous devices. However, despite successful recanalization rates (Treatment in Cerebral Infarction, TICI, score ≥ 2b) between 70 and 90%, good clinical outcomes assessed by modified Rankin Scale (mRS) ≤ 2 is present in 40-50% of patients . We aimed to evaluate predictors of poor outcomes (mRS > 2) despite successful recanalization (TICI ≥ 2b) in the acute stroke patients treated with the Solitaire device of the North American Solitaire Stent Retriever Acute Stroke (NASA) registry. Methods: The NASA registry is a multicenter, non-sponsored, physician-conducted, post-marketing registry on the use of SOLITAIRE FR device in 354 acute, large vessel, ischemic stroke patients. Logistic regression was used to evaluate patient characteristics and treatment parameters for association with 90-day mRS score of 0-2 (good outcome) versus 3-6 (poor outcome) within patients who were recanalized successfully (Thrombolysis in Cerebral Infarction or TICI score 2b-3). Univariate tests were followed by development of a multivariable model based on stepwise selection with entry and retention criteria of p < 0.05 from the set of factors with at least marginal significance (p ≤ 0.10) on univariate analysis. The c-statistic was calculated as a measure of predictive power. Results: Out of 354 patients, 256 (72.3%) were successfully recanalized (TICI ≥ 2b). Based on 90-day mRS score for 234 of these patients, there were 116 (49.6%) with mRS > 2. Univariate analysis identified increased risk of mRS > 2 for each of the following: age ≥ 80 years (upper quartile of data), occlusion site other than M1/M2, NIH Stroke Scale (NIHSS) score ≥ 18 (median), history of diabetes mellitus (DM), TICI = 2b, use of rescue therapy, not using a balloon-guided catheter (BGC) or intravenous tissue plasminogen activator (IV t-PA), and time to recanalization > 30 minutes (all p ≤ 0.05). Three or more passes was marginally significant (p=0.097). In multivariable analysis, age ≥ 80 years, site other than M1/M2, initial NIHSS ≥18, DM, absence of IV t-PA, use of rescue therapy and three or more passes were significant independent predictors of poor 90-day outcome in a model with good predictive power (c-index = 0.80). Conclusions: Age, occlusion site, high NIHSS, diabetes, not receiving IV t-PA, use of rescue therapy and three or more passes, were associated with poor 90-day outcome despite successful recanalization.

scholarly journals Elevation of troponin I in acute ischemic stroke

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1866 ◽  
Author(s):  
Yu-Chin Su ◽  
Kuo-Feng Huang ◽  
Fu-Yi Yang ◽  
Shinn-Kuang Lin
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Barthel Index ◽  
Troponin I ◽  
Clinical Deterioration ◽  
Stroke Severity ◽  
Nihss Score ◽  
Poor Outcome

Background. Cardiac morbidities account for 20% of deaths after ischemic stroke and is the second commonest cause of death in acute stroke population. Elevation of cardiac troponin has been regarded as a prognostic biomarker of poor outcome in patients with acute stroke.Methods. This retrospective study enrolled 871 patients with acute ischemic stroke from August 2010 to March 2015. Data included vital signs, laboratory parameters collected in the emergency department, and clinical features during hospitalization. National Institutes of Health Stroke Scale (NIHSS), Barthel index, and modified Rankin Scale (mRS) were used to assess stroke severity and outcome.Results.Elevated troponin I (TnI) > 0.01 µg/L was observed in 146 (16.8%) patients. Comparing to patients with normal TnI, patients with elevated TnI were older (median age 77.6 years vs. 73.8 years), had higher median heart rates (80 bpm vs. 78 bpm), higher median white blood cells (8.40 vs. 7.50 1,000/m3) and creatinine levels (1.40 mg/dL vs. 1.10 mg/dL), lower median hemoglobin (13.0 g/dL vs. 13.7 g/dL) and hematocrit (39% vs. 40%) levels, higher median NIHSS scores on admission (11 vs. 4) and at discharge (8 vs. 3), higher median mRS scores (4 vs3) but lower Barthel index scores (20 vs. 75) at discharge (p< 0.001). Multivariate analysis revealed that age ≥ 76 years (OR 2.25, CI [1.59–3.18]), heart rate ≥ 82 bpm (OR 1.47, CI [1.05–2.05]), evidence of clinical deterioration (OR 9.45, CI [4.27–20.94]), NIHSS score ≥ 12 on admission (OR 19.52, CI [9.59–39.73]), and abnormal TnI (OR 1.98, CI [1.18–3.33]) were associated with poor outcome. Significant factors for in-hospital mortality included male gender (OR 3.69, CI [1.45–9.44]), evidence of clinical deterioration (OR 10.78, CI [4.59–25.33]), NIHSS score ≥ 12 on admission (OR 8.08, CI [3.04–21.48]), and elevated TnI level (OR 5.59, CI [2.36–13.27]).C-statistics revealed that abnormal TnI improved the predictive power of both poor outcome and in-hospital mortality. Addition of TnI > 0.01 ug/L or TnI > 0.1 ug/L to the model-fitting significantly improvedc-statistics for in-hospital mortality from 0.887 to 0.926 (p= 0.019) and 0.927 (p= 0.028), respectively.Discussion.Elevation of TnI during acute stroke is a strong independent predictor for both poor outcome and in-hospital mortality. Careful investigation of possible concomitant cardiac disorders is warranted for patients with abnormal troponin levels.

Abstract WMP58: The Smoker’s Paradox After Acute Ischemic Stroke, is it Real or a Cloud of Smoke?

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Eva Mistry ◽  
Shadi Yaghi ◽  
Pooja Khatri ◽  
Shyam Prabhakaran
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Tobacco Use ◽  
Neurologic Outcome ◽  
Stroke Patients ◽  
Logistic Regression Models ◽  
Neurological Outcomes ◽  
Good Outcome ◽  
Adjusted Model

Background: Although tobacco use, the majority of which is cigarette smoking, increases the risk of incident stroke, there are inconsistent data regarding the effect of tobacco use on neurological outcomes after acute ischemic stroke. Several prior studies have suggested that smoking could be protective after stroke, which has been termed the "smoker’s paradox." Methods: We pooled three data sources to explore the effect of tobacco use on neurologic outcome in acute stroke patients. The first was the Blood Pressure after EVT in Stroke (BEST) study, the second was the NINDS tPA trial, and the third was the Interventional Management of Stroke (IMS) III trial. The primary outcome is 90-day mRS 0-2 (good outcome). We fit logistic regression models to good outcome, both unadjusted and adjusted for patient age, NIHSS, and sICH. Results: Our pooled cohort had 1,671 acute stroke patients, of which 480 (28.7%) used tobacco. In an unadjusted model, tobacco use was associated with good outcome (OR 1.42, 95% CI 1.15-1.76, p=0.001). However, in the adjusted model, this association was no longer significant (aOR 0.98, 95% CI 0.76-1.25, p=0.868). If we stratify by placebo-treated (n=310), tPA-treated (n=513), and EVT-treated (n=836), we continue to find that tobacco use is not associated with good neurologic outcome in adjusted analyses specific to these subgroups. An additional subgroup analysis of the EVT-treated patients that adjusted for successful procedural recanalization (TICI 2b-3) was not significant. Patients who used tobacco were younger (mean age, 60.5 vs. 69.2 years, p<0.001). Adjusting for age alone rendered the association between tobacco use and good outcome insignificant (aOR 1.05, 95% CI 0.84-1.32, p=0.666). Conclusions: This is the first adjusted analysis to examine the association between tobacco use and neurologic outcome in EVT-treated patients. We find that tobacco use is not protective after acute ischemic stroke that is untreated or treated with tPA or EVT. The univariate association of tobacco use with good outcome is accounted for by tobacco users being younger.

Defining Minor Symptoms in Acute Ischemic Stroke

2015 ◽  
Vol 39 (3-4) ◽  
pp. 209-215 ◽  
Author(s):  
Davide Strambo ◽  
Alberto A. Zambon ◽  
Luisa Roveri ◽  
Giacomo Giacalone ◽  
Giovanni Di Maggio ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Motor Impairment ◽  
Epidemiological Data ◽  
Minor Stroke ◽  
Predictors Of Outcome ◽  
Stroke Patients ◽  
Nihss Score ◽  
Poor Outcome ◽  
Definition Of

Background: Thrombolysis is often withheld from acute ischemic stroke patients presenting with mild symptoms; however, up to 40% of these patients end up with a poor outcome when left untreated. Since there is lack of consensus on the definition of minor symptoms, we aimed at addressing this issue by looking for features that would better predict functional outcomes at 3 months. Methods: Among all acute ischemic stroke patients admitted to our Stroke Unit (n = 1,229), we selected a cohort of patients who arrived within 24 hours from symptoms onset, with baseline NIHSS ≤6, not treated with thrombolysis (n = 304). Epidemiological data, comorbidities, radiological features and clinical presentation (NIHSS items) were collected to identify predictors of outcome. Our cohort was tested against minor stroke definitions selected from the literature and a newly proposed one. Results: Three months after stroke onset, 97 patients (31.9%) had mRS ≥2. Independent predictors of poor outcome were age (OR 0.97 [95% CI 0.95-9.99]) and baseline NIHSS score (OR 0.79 [95% CI 0.67-0.94]), while cardioembolic aetiology was negatively associated (OR 3.29 [95% CI 1.51-7.14]). Items of NIHSS associated with poor outcome were impairment of right motor arm (OR 0.49 [95% CI 0.27-0.91]) or the involvement of any of the motor items (OR 0.69 [95% CI 0.48-0.99]). The definition of minor stroke as NIHSS ≤3 and the new proposed definition had the highest sensitivity and accuracy and were independent predictors of outcome. Conclusions: Our study confirmed that in spite of a low NIHSS score, one third of patients had poor outcome. As already described, age and NIHSS score remained independent predictors of poor outcome even in mild stroke. Also, motor impairment appeared a major determinant of poor outcome. The new proposed definition of minor stroke featured the NIHSS score and the NIHSS items that better predicted functional outcome. Awareness that even minor stroke can yield to poor outcome should sensitize patients to arrive early to the ED and neurologists to administer rt-PA.

Abstract 2268: Trends In Reasons For Non-eligibility For tPA

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Xin Tong ◽  
Mary G George
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Advanced Age ◽  
Stroke Patients ◽  
Rapid Improvement ◽  
Nihss Score ◽  
Mild Stroke ◽  
Over Time ◽  
Iv Tpa

Background: Use of IV tPA has increased over time, as has the adherence to the NQF endorsed performance measure for receipt of IV tPA within 3 hours. Little is known about trends in the reasons for patient ineligibility for IV tPA. This study examines trends in reasons for not providing IV tPA over time and by race and gender among acute ischemic stroke patients in the Paul Coverdell National Acute Stroke Registry (PCNASR), a quality improvement program for acute stroke implemented by state health departments. Methods: There were 13,164 PCNASR patients enrolled from 2008- 2010 with a clinical diagnosis of acute ischemic stroke with documentation of LKW and who arrived within 2 hours of LKW. Cochran-Armitage tests were used to test for trend on accepted reasons for not providing IV tPA within 3 hours of time last known well (LKW). Chi-square tests were used to test for differences among reasons between men and women and between non-Hispanic whites and minorities. Multiple reasons for not giving tPA could be selected. Results: Among 13,164 acute ischemic patients admitted between 2008 and 2010 with documentation of LKW and who arrived within 2 hours of LKW, 3781 (28.7%) received IV tPA, 7284 (55.3%) had documented reasons for not receiving IV tPA, and 2099 (16.0%) did not receive IV tPA. Contraindications to IV tPA, advanced age, rapid improvement and inability to determine eligibility increased over time. Mild stroke decreased over time. Conditions with warning, advanced age, limited life expectancy and family refusal were more common in women; mild stroke and rapid improvement were more common in men. Contraindications were more common in minorities; advanced age, mild stroke and rapid improvement, and family refusal were more common in non-Hispanic whites. When advanced age was selected, 46.6% of patients were over age 90 and 3.4% were under age 80. When stroke too mild was selected, 44.8% of patients had missing NIHSS scores, 42.1% of scores were 0-4, 8.8% were 5-9, and 4.3% were ≥ 10. The three most common reasons for not providing tPA were rapid improvement (40.9%), mild stroke (33.0%), and contraindications (29.2%) in 2010. Conclusions: More than half of ischemic stroke patients arriving within 2 hours of LKW were ineligible to receive IV tPA. There was little use of advanced age for patients under age 80. Documentation of stroke too mild was not substantiated by an NIHSS score in nearly half of patients. Better documentation of NIHSS score should be provided.

Abstract P85: Impact of Covid-19 Pandemic on Hospitalizations and Outcomes of Acute Ischemic Stroke Patients, Paul Coverdell National Acute Stroke Program (pcnasp)

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Xin Tong ◽  
Sallyann Coleman King ◽  
Erika Odom ◽  
Quanhe Yang
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Reperfusion Therapy ◽  
The United States ◽  
Emergency Department Visits ◽  
National Institutes Of Health ◽  
Hospital Death ◽  
Stroke Patients ◽  
Stroke Treatment

Introduction: Studies suggest a significant reduction in emergency department visits and hospitalizations for acute ischemic stroke (AIS) during the COVID-19 pandemic in the United States. Few studies have examined AIS hospitalizations, treatments, and outcomes during the pandemic period. The present study compared the demographic and clinical characteristics of patients hospitalized with AIS before and during the COVID-19 pandemic (weeks 11-24 in 2019 vs. 2020). Method: We identified 42,371 admissions with a clinical diagnosis of AIS, from 370 participating hospitals who contributed data during weeks 11-24 in both 2019 and 2020 to the Paul Coverdell National Acute Stroke Program (PCNASP). Results: During weeks 11-24 of the COVID-19 period, AIS hospitalizations declined by 24.5% compared to the same period in 2019 (18,233 in 2020 vs. 24,138 in 2019). In 2020, the percentage of individuals aged <65 years who were hospitalized with AIS was higher compared with the same period in 2019 (34.6% vs. 32.7%, p<0.001); arriving by EMS were higher in 2020 compared with 2019 (47.7% vs. 44.8%, p<0.001). Individuals admitted with AIS in 2020 had a higher mean National Institutes of Health Stroke Scale (NIHSS) score compared with 2019 (6.7 vs. 6.3, p<0.001). In 2020, the in-hospital death rates increased by 16% compared to 2019 (5.0% vs. 4.3%, p<0.001). However, there were no differences in rates of alteplase use, achievement of door to needle in 60 minutes, or complications from reperfusion therapy between the two time periods. Conclusion: A higher percentage of younger (<65 years) individuals and more severe AIS cases were admitted to the participating hospitals during weeks 11 to 24 of the COVID-19 pandemic in 2020 compared to the same period in 2019. The AIS in-hospital death rate increased 16% during the pandemic weeks as compared to the same weeks in 2019. Additional studies are needed to examine the impacts of the COVID-19 pandemic on stroke treatment and outcomes.

scholarly journals Comparative study of back propagation artificial neural networks and logistic regression model in predicting poor prognosis after acute ischemic stroke

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 324-330 ◽  
Author(s):  
Yaru Liang ◽  
Qiguang Li ◽  
Peisong Chen ◽  
Lingqing Xu ◽  
Jiehua Li
Keyword(s):  
Neural Networks ◽  
Alkaline Phosphatase ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Poor Prognosis ◽  
Diagnostic Performance ◽  
Back Propagation ◽  
Stroke Patients ◽  
Poor Outcome ◽  
The Poor

AbstractObjectiveTo investigate the predictive value of clinical variables on the poor prognosis at 90-day follow-up from acute stroke onset, and compare the diagnostic performance between back propagation artificial neural networks (BP ANNs) and Logistic regression (LR) models in predicting the prognosis.MethodsWe studied the association between clinical variables and the functional recovery of 435 acute ischemic stroke patients. The patients were divided into 2 groups according to modified Rankin Scale scores evaluated on the 90th day after stroke onset. Both BP ANNs and LR models were established for predicting the poor outcome and their diagnostic performance were compared by receiver operating curve.ResultsAge, free fatty acid, homocysteine and alkaline phosphatase were closely related with the poor outcome in acute ischemic stroke patients and finally enrolled in models. The accuracy, sensitivity and specificity of BP ANNs were 80.15%, 75.64% and 82.07% respectively. For the LR model, the accuracy, sensitivity and specificity was 70.61%, 88.46% and 63.04% respectively. The area under the ROC curve of the BP ANNs and LR model was 0.881and 0.809.ConclusionsBoth BP ANNs and LR model were promising for the prediction of poor outcome by combining age, free fatty acid, homocysteine and alkaline phosphatase. However, BP ANNs model showed better performance than LR model in predicting the prognosis.

Abstract TP151: Association of Splenic Contraction And Development of Systemic Inflammatory Response Syndrome After Acute Ischemic Stroke

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Alicia M Zha ◽  
Bhargav Tippinayani ◽  
Jaskaren Randhawa ◽  
Nicole J Pariseau ◽  
Farhaan S Vahidy ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Systemic Inflammatory Response Syndrome ◽  
Inflammatory Response ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Care Center ◽  
Tertiary Care ◽  
Systemic Inflammatory Response ◽  
Secondary Brain Injury ◽  
Stroke Patients

Background: Animal models have demonstrated the deleterious contribution that immunocytes from the spleen exert on secondary brain injury after stroke. While previous work has demonstrated that there is splenic contraction (SC) in patients with acute ischemic stroke (AIS) and intracranial hemorrhage (ICH), no clinical studies have connected the systemic inflammatory response syndrome (SIRS) with SC. We aim to associate SIRS and its individual components with SC in acute stroke Methods: This is a retrospective analysis of a previous prospective observational study where daily spleen sizes were evaluated in 178 acute stroke patients in a tertiary care center from 2010-2013. Spleen contraction was defined compared to previously established normograms of healthy volunteers from the same study. SIRS was defined as the presence of 2 or more of the following: body temperature <36 or >38C, heart rate >90 beats, respiratory rate >20, and serum white blood cell count >12,000 or <4000 mm3 in the absence of infection. SC was evaluated in patients at 24 and 72 hrs after AIS with SIRS as a primary outcome. Results: 91 patients had verified AIS without concurrent infection at admission and 70 of these patients remained inpatient at 72 hrs. SIRS was not associated with admission SC at 24hr and 72 hrs. Patients with SIRS at 24 and 72 hrs were more likely to have higher admission NIHSS. SIRS was associated with higher discharge mRS (OR 4.24, 95% CI 1.64-10.9, p=0.0028) and PEG placement (OR 3.70, 95% CI 0.95-15.11, p=0.05). 16 patients (22.9%) developed SIRS by 72hrs, only 5 of whom had SC initially. 28 patients (47%) had SIRS on admission that persisted, 12 of whom had SC. SC was not associated with SIRS at 72 hrs (OR 1.05, 95% CI 0.35-2.79, p = 0.92). 14 patients (15%) developed infections while hospitalized, of which 85% had SIRS on admission. Conclusion: Based on our initial evaluation, SC detected within 24 hrs of stroke onset is not associated with SIRS suggesting that the relationship between the two may be more complicated in humans. Consistent with prior studies, however, SIRS is associated with worse outcome. Further studies and additional time points are necessary to further clarify the role of the spleen in the development of SIRS in stroke patients.

RESEARCH IN SERUM COPEPTIN CONCENTRATION IN THE ACUTE STROKE PATIENTS

2017 ◽  
pp. 156-163
Author(s):  
Thanh Cong Nguyen ◽  
Thi Bich Thuan Le ◽  
Chuyen Le ◽  
Thi Minh Phuong Phan
Keyword(s):  
Ischemic Stroke ◽  
Glasgow Coma Scale ◽  
Intracerebral Hemorrhage ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Scale Score ◽  
Glasgow Coma Scale Score ◽  
Stroke Patients ◽  
Nihss Score ◽  
Coma Scale

Objectives: To determine serum Copeptin concentration and correlation between serum Copeptin concentration with some major predictors of acute stroke patients (ischemic stroke and intracerebral hemorrhage). Subjects and Methods: Cross-sectional descriptive study with 72 patients (40 acute ischemic stroke patients and 32 intracerebral hemorrhage patients at Hue University Hospital. Data processing method is according to usual medical statistics and SPSS 20.0. Results: 1. The serum Copeptin concentration in the patients with acute stroke: - The serum Copeptin concentration in the patients with acute ischemic stroke was 11.28 ± 5.2 pmol/L (admission) and 8.81 ± 4.94 pmol/L (after 7 days). - The serum Copeptin concentration in the patients with acute intracerebral hemorrhage was 9.17 ± 7.97 pmol/L (admission) and 7.14 ± 6.62 pmol/L (after 7 days). - The serum Copeptin concentration in the patients with acute stroke at admission and after 7 days there was not statistically significant difference between female and male (p > 0.05). 2. The correlation between serum Copeptin concentration and severity of acute stroke patients: - The serum Copeptin concentration correlated positively with size of injury (ischemic stroke: r = 0.743; p< 0.001 and intracerebral hemorrhage: r = 0.502; p= 0.003). - The serum Copeptin concentration in the acute stroke patients correlated positively with NIHSS score at admission (ischemic stroke: r = 0.657, p < 0.001 and intracerebral hemorrhage: r = 0.408, p = 0.021). - The serum Copeptin concentration in the acute stroke patients correlated positively with NIHSS score after 7 days (ischemic stroke: r = 0.486, p < 0.001 and intracerebral hemorrhage: r = 0.359, p = 0.044). - The serum Copeptin concentration in the acute stroke patients correlated negatively with Glasgow Coma Scale score at admission (ischemic stroke: r = - 0.564, p < 0.001 and intracerebral hemorrhage: r = - 0.466, p = 0.007).The serum Copeptin concentration in the acute stroke patients correlated negatively with Glasgow Coma Scale score after 7 days (ischemic stroke: r = - 0.499, p < 0.001 and intracerebral hemorrhage: r = - 0.38, p = 0.032). Conclusions: There was correlation between serum Copeptin concentration with severity of acute stroke patients. Key words: Copeptin, acute stroke, ischemic stroke, intracerebral hemorrhage

scholarly journals Minor Non-Disabling Stroke Patients with Large Vessel Severe Stenosis or Occlusion Might Benefit from Thrombolysis

2021 ◽  
Vol 11 (7) ◽  
pp. 945
Author(s):  
Wansi Zhong ◽  
Ying Zhou ◽  
Kemeng Zhang ◽  
Shenqiang Yan ◽  
Jianzhong Sun ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Clinical Practice ◽  
Acute Ischemic Stroke ◽  
National Institutes Of Health ◽  
Stroke Patients ◽  
Severe Stenosis ◽  
Nihss Score ◽  
Excellent Outcome ◽  
Practice Methods ◽  
Large Vessels

Background: The benefit of alteplase in minor non-disabling acute ischemic stroke (AIS) is unknown. We aimed to explore the clinical efficacy of alteplase-treatment in minor non-disabling stroke in clinical practice. Methods: We used a prospectively collected database of AIS patients who were being assessed for thrombolysis with alteplase. Minor non-disabling AIS was identified as patients with baseline National Institutes of Health Stroke Scale (NIHSS) score ≤ 5 and a score 0 or 1 on each baseline NIHSS score item (items 1a to 1c being 0). Results: A total of 461 patients with minor non-disabling AIS were included and among them 240 (52.1%) patients were treated with alteplase and 113 (24.5%) patients had severe stenosis/occlusion of large vessels. No significant association of 90-day excellent outcome was found with alteplase-treatment (77.1% vs. 80.5%, p 1 = 0.425; OR 0.911, 95% CI 0.428 to 1.940; p 2 = 0.808). However, among patients with severe stenosis/occlusion of large vessels, alteplase-treatment was independently associated with excellent outcome (74.4% vs. 45.7%, p 1 = 0.005; OR 4.709, 95% CI 1.391 to 11.962; p 2 = 0.010). Conclusion: Although alteplase-treatment did not result in an excellent outcome in general minor non-disabling stroke patients, it may work in those specific patients who had severe stenosis/occlusion of large vessels.

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