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.
Artículo
en Coreano
| 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)
Texto completo:
Disponible
Índice:
WPRIM (Pacífico Occidental)
Asunto principal:
Encéfalo
/
Terapia Trombolítica
/
Infarto Cerebral
/
Factores de Riesgo
/
Resultado del Tratamiento
/
Activador de Tejido Plasminógeno
/
Accidente Cerebrovascular
/
Hemorragias Intracraneales
/
National Institute of Neurological Disorders and Stroke (U.S.)
/
Corea (Geográfico)
Tipo de estudio:
Estudio de etiología
/
Guía de Práctica Clínica
/
Estudio pronóstico
/
Factores de riesgo
Límite:
Humanos
País/Región como asunto:
Asia
Idioma:
Coreano
Revista:
Journal of the Korean Neurological Association
Año:
2001
Tipo del documento:
Artículo
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