Assessment of prognosis in acute ischemic stroke patients after the treatment performed in the first 24 hours

Objective: The high disability and mortality rates due to cerebrovascular causes reveal the need for large sample studies on the diagnosis, treatment and follow-up processes in the local population. In this study, we aimed to evaluate the prognosis of acute ischemic stroke patients after the acute ischemic stroke treatment performed in the first 24 hours. Method: The study included 371 patients with acute ischemic stroke who were admitted to the Neurology Department, Stroke Unit and Neurology Intensive Care Unit of Dokuz Eylül University Education and Practice Hospital between August 2013 and August 2018. All the data of the patients in the hospital electronic databases were reached and evaluated retrospectively. Results: When the total number of complications occured after acute ischemic stroke treatment and the rate of discharges without complications were evaluated, it is seen that intravenous thrombolysis (IV tPA) group has less number of complications than mechanical thrombectomy (MT) (p = 0.001) and other endovascular treatments (p = 0.031). Besides, the discharging rates without complications in the IV tPA group (33.8%) were higher than the other groups (p = 0.045). When the length of stay in hospital is considered, it was observed that patients who received IV tPA had a shorter hospitalization rate than patients treated with MT (p = 0.030) and patients treated with IV tPA and MT (p = 0.004). Conclusions: It was observed that the group received IV tPA had a better prognosis compared to the other groups. This difference between treatment groups cannot be explained by clinical evaluation findings, current risk factors and demographic profiles of patients. Additionally, it has been shown that male gender, hypertension and high blood pressure at the time of admission to the emergency room adversely affect the prognosis of acute ischemic stroke independently of the treatment performed in the first 24 hours. Keywords: Acute Ischemic Stroke, Intravenous Thrombolysis, Mechanical Thrombectomy, Prognosis