Retrospective evaluation of the mortality of patients receiving intravenous thrombolytic therapy WHO were admitted to the emergency department DUE to ischemic stroke

The best approved viable treatment option is intravenous thrombolytic (IVT) therapy with recombinant tissue plasminogen activator (rtPA). With this treatment, it is aimed to eliminate the neurological deficit that occurs in patients who have had an ischemic stroke by intervening within the shortest possible time and to minimize the deterioration in a person's daily functions as much as possible. The reason why this treatment can be applied to every patient is that the initial period of treatment is limited and there are some contraindications. This limitation comes across as a serious disadvantage. There is also a serious complication scale that extends to death. The aim of this study is to determine which group of patients benefited from the treatment applied in our hospital, to determine the parameters affecting mortality and to contribute to the literature, especially the data recorded after intravenous thrombolytic treatment given to stroke patients who are frequently admitted to emergency departments. Materials and Methods: January August 2018 to August 2022, the emergency department admissions, hospitalization registered in the system and file and outpatient follow-ups of patients admitted to the emergency department of Uşak University Education and Research Hospital with stroke symptoms, proven to be ischemic stroke, thrombolytic treatment started within the first 4.5 hours and were followed up by admission were retrospectively examined in our current study. the patient's emergency department admissions, hospitalization and outpatient follow-ups were retrospectively examined. Dec.2018 to August 2022, the patients were admitted to the emergency department of Uşak University Education and Research Hospital with stroke symptoms, proved to be ischemic stroke, and were admitted to the emergency department within the first 4.5 hours. Results: The data of 184 patients who met the criteria were obtained. It was found that 42 (22.8%) of the 184 patients in the study group had ex during follow-up. While there was no difference between male and female gender in terms of mortality rate; This frequency was found to be higher in those aged 65 and over (p<0.05). At the same time, it was determined that the mortality rate was higher in patients who applied to the emergency department with 112 emergency health services compared to the outpatients (p<0.05). It was determined that the mortality frequency of those who had a serious stroke (21 points and above) in the NIHSS score was higher (p<0.05). In our study, it was determined that the length of hospital stay was also associated with mortality (p<0.05). It has been shown that patients hospitalized for more than 14 days are more mortal. In the results obtained from the univariate analysis, age, admission status, hospitalization day, and multiple logistic regression analysis with NIHSS score, which are thought to be associated with mortality status, in terms of mortality, compared to those with a NIHSS score of 21 and above and a score of 20 or below, with an OR of 18.49 (6.55-52.20). (95% CI) was found to be times more risky. Conclusions: In our study, it was determined that age, presentation type, NIHSS score at the time of admission, length of stay, and DM and AF, which are comorbid conditions, affect mortality.