Novel Definition of Stroke "Good Responders" Predicts 90-Day Outcome after Thrombolysis.
J Stroke Cerebrovasc Dis
; 28(12): 104422, 2019 Dec.
Article
en En
| MEDLINE
| ID: mdl-31624038
ABSTRACT
INTRODUCTION:
Identifying predictors of good response in thrombolytic-treated stroke is important to clinical care, resource allocation, and research design. We developed a simple, novel measure of "Good Responders" to assess if 2 short-term variables could predict 90-day outcomes after thrombolysis in stroke.METHODS:
Intravenous thrombolysis-treated stroke cases from June 2004 to June 2018 were analyzed from a stroke registry. Intraarterial treatment cases were excluded. Good responders (GR++) were defined as those with length of stay less than or equal to 3 days and discharge to home. Poor responders (GR- -) had length of stay more than 3 days and discharge other than home. Mixed responders (GR+/-) composed the remainder. Baseline characteristics and predictors of 90-day outcome were assessed.RESULTS:
Of 261 patients, there were 101(38.7%) GR++, 67(25.7%) GR- -, and 93(35.6%) GR+/-. For GR++ versus GR- -â¯versus GR+/-, there were differences in mean age (62.7, 71.2, 69.2; Pâ¯=â¯.0016), and baseline modified Rankin score (mRS) 0-2 (% 94.9, 74.6, 84.8; Pâ¯=â¯.008). Younger age, male sex, lower values for systolic BP, glucose, and baseline mRS were associated with good responders. Older age, atrial fibrillation, symptomatic intracerebral hemorrhage, and baseline mRS greater than 2 were associated with poor responders. At 90 days, mortality was reduced in GR++ versus GR- - versus GR+/- (%alive 92.6, 72, 86; Pâ¯=â¯.04), and mRS(0-2) (% 36.8, 0, 11.8; P < .001).CONCLUSIONS:
Good responders to thrombolysis are younger and have better baseline functional status. Our novel definition of "Good Responders", using 2 early variables of home disposition and short length of stay, may help predict 90-day post-thrombolytic outcome. Future work should focus on validating this definition.Palabras clave
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Terapia Trombolítica
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Accidente Cerebrovascular
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Fibrinolíticos
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Terminología como Asunto
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Stroke Cerebrovasc Dis
Asunto de la revista:
ANGIOLOGIA
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CEREBRO
Año:
2019
Tipo del documento:
Article