Intravenous r-tPA Therapy in Acute Ischemic Stroke: The Implication of Immediate Neurological Improvement for the Long-term Outcome
Journal of the Korean Neurological Association
;
: 364-369, 2001.
Article
in Korean
| WPRIM
| ID: wpr-207615
ABSTRACT
BACKGROUND:
Intravenous recombinant tissue plasminogen activator (r-tPA) infusion is the only established treatment for acute ischemic stroke so far. We explored whether the demonstrated efficacy of r-tPA could be applied to communi-ty-based hospitals in Korea and whether the immediate improvements after r-tPA infusion had any predicting value for long-term outcomes.METHODS:
Twenty-six patients (mean age, 69; 46% female) with acute ischemic stroke were treated with r-tPA, abiding by the National Institute of Neurological Disorders and Stroke (NINDS) protocol. The Neurological status was measured with the National Institutes of Health Stroke Scale (NIHSS) at baseline, at 1 hour after r-tPA , at 24 hours, and at 7 days and the functional outcome was evaluated with the modified Rankin scale (mRS) and Barthel Index at 90 days after stroke.RESULTS:
Of 26 patients, 16 (62%) made full recovery or became independent, 4 (15%) had severe physical disability, and 6 (23%) patients died. Three patients (11.5%) had intracranial hemorrhage (asymptomatic, 2; symptomatic, 1). There were no significant differences in age, sex, risk factors, baseline NIHSS scores, hemorrhagic complication, initial brain CT abnormalities, and onset to needle time between good (full recovery or mRS 0-2) and poor groups (mRS 3-5 or death) at day 90, except for the improvement of NIHSS examined at 1 hour after r-tPA (repeated measured ANOVA test, p<0.01). CONCLUSIONS The NINDS r-tPA protocol is feasible in the community-based hospitals in Korea with the safety and efficacy comparable to the results of NINDS r-tPA trials. In addition, we suggest that the immediate neurological improvement after r-tPA be a predictor for favorable long-term outcomes. (J Korean Neurol Assoc 19(4)364~369, 2001)
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Brain
/
Thrombolytic Therapy
/
Cerebral Infarction
/
Risk Factors
/
Treatment Outcome
/
Tissue Plasminogen Activator
/
Stroke
/
Intracranial Hemorrhages
/
National Institute of Neurological Disorders and Stroke (U.S.)
/
Korea
Type of study:
Etiology study
/
Practice guideline
/
Prognostic study
/
Risk factors
Limits:
Humans
Country/Region as subject:
Asia
Language:
Korean
Journal:
Journal of the Korean Neurological Association
Year:
2001
Type:
Article
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