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  • Background and Purpose Little is known about the effect of thrombolysis in patients with preexisting disability. Our aim was to evaluate the impact of different levels of prestroke disability on patients' profile and outcome after intravenous thrombolysis. Methods We analyzed the data of all stroke patients admitted between October 2003 and December 2011 that were contributed to the Safe Implementation of Treatments in Stroke-Eastern Europe (SITS-EAST) registry. Patients with no prestroke disability at all (modified Rankin Scale [mRS] score, 0) were used as a reference in multivariable logistic regression. Results Of 7250 patients, 5995 (82%) had prestroke mRS 0, 791 (11%) had prestroke mRS 1, 293 (4%) had prestroke mRS 2, and 171 (2%) had prestroke mRS 3. Compared with patients with mRS 0, all other groups were older, had more comorbidities, and more severe neurological deficit on admission. There was no clear association between preexisting disability and the risk of symptomatic intracranial hemorrhage. Prestroke mRS 1, 2, and 3 were associated with increased risk of death at 3 months (odds ratio, 1.3, 2.0, and 2.6, respectively) and lower chance of achieving favorable outcome (achieving mRS 0-2 or returning to the prestroke mRS; 0.80, 0.41, 0.59, respectively). Patients with mRS 3 and 2 had similar vascular profile and favorable outcome (34% versus 29%), despite higher mortality (48% versus 39%). Conclusions Prestroke disability does not seem to independently increase the risk of symptomatic intracranial hemorrhage after thrombolysis. Despite higher mortality, 1 in 3 previously disabled patients may return to his/her prestroke mRS. Therefore, they should not be routinely excluded from thrombolytic therapy.
  • Background and Purpose Little is known about the effect of thrombolysis in patients with preexisting disability. Our aim was to evaluate the impact of different levels of prestroke disability on patients' profile and outcome after intravenous thrombolysis. Methods We analyzed the data of all stroke patients admitted between October 2003 and December 2011 that were contributed to the Safe Implementation of Treatments in Stroke-Eastern Europe (SITS-EAST) registry. Patients with no prestroke disability at all (modified Rankin Scale [mRS] score, 0) were used as a reference in multivariable logistic regression. Results Of 7250 patients, 5995 (82%) had prestroke mRS 0, 791 (11%) had prestroke mRS 1, 293 (4%) had prestroke mRS 2, and 171 (2%) had prestroke mRS 3. Compared with patients with mRS 0, all other groups were older, had more comorbidities, and more severe neurological deficit on admission. There was no clear association between preexisting disability and the risk of symptomatic intracranial hemorrhage. Prestroke mRS 1, 2, and 3 were associated with increased risk of death at 3 months (odds ratio, 1.3, 2.0, and 2.6, respectively) and lower chance of achieving favorable outcome (achieving mRS 0-2 or returning to the prestroke mRS; 0.80, 0.41, 0.59, respectively). Patients with mRS 3 and 2 had similar vascular profile and favorable outcome (34% versus 29%), despite higher mortality (48% versus 39%). Conclusions Prestroke disability does not seem to independently increase the risk of symptomatic intracranial hemorrhage after thrombolysis. Despite higher mortality, 1 in 3 previously disabled patients may return to his/her prestroke mRS. Therefore, they should not be routinely excluded from thrombolytic therapy. (en)
Title
  • Role of Preexisting Disability in Patients Treated With Intravenous Thrombolysis for Ischemic Stroke
  • Role of Preexisting Disability in Patients Treated With Intravenous Thrombolysis for Ischemic Stroke (en)
skos:prefLabel
  • Role of Preexisting Disability in Patients Treated With Intravenous Thrombolysis for Ischemic Stroke
  • Role of Preexisting Disability in Patients Treated With Intravenous Thrombolysis for Ischemic Stroke (en)
skos:notation
  • RIV/00159816:_____/14:00060745!RIV15-MSM-00159816
http://linked.open...avai/riv/aktivita
http://linked.open...avai/riv/aktivity
  • P(ED1.100/02/0123)
http://linked.open...iv/cisloPeriodika
  • 3
http://linked.open...vai/riv/dodaniDat
http://linked.open...aciTvurceVysledku
http://linked.open.../riv/druhVysledku
http://linked.open...iv/duvernostUdaju
http://linked.open...titaPredkladatele
http://linked.open...dnocenehoVysledku
  • 43169
http://linked.open...ai/riv/idVysledku
  • RIV/00159816:_____/14:00060745
http://linked.open...riv/jazykVysledku
http://linked.open.../riv/klicovaSlova
  • treatment outcome; thrombolytic therapy; stroke; comorbidity (en)
http://linked.open.../riv/klicoveSlovo
http://linked.open...odStatuVydavatele
  • US - Spojené státy americké
http://linked.open...ontrolniKodProRIV
  • [A224952F90C7]
http://linked.open...i/riv/nazevZdroje
  • Stroke
http://linked.open...in/vavai/riv/obor
http://linked.open...ichTvurcuVysledku
http://linked.open...cetTvurcuVysledku
http://linked.open...vavai/riv/projekt
http://linked.open...UplatneniVysledku
http://linked.open...v/svazekPeriodika
  • 45
http://linked.open...iv/tvurceVysledku
  • Mikulík, Robert
  • Ahmed, Niaz
  • Wahlgren, Nils
  • Korv, Janika
  • Krespi, Yakup
  • Vilionskis, Aleksandras
  • Czlonkowska, Anna
  • Brozman, Miroslav
  • Csiba, Laszlo
  • Demarin, Vida
  • Fekete, Klara
  • Jatuzis, Dalius
  • Karlinski, Michal
  • Kobayashi, Adam
  • Svigelj, Viktor
  • Vaclavik, Daniel
http://linked.open...ain/vavai/riv/wos
  • 000331876800037
issn
  • 0039-2499
number of pages
http://bibframe.org/vocab/doi
  • 10.1161/STROKEAHA.113.003744
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