Outcomes of Thai patients with acute ischemic stroke after intravenous thrombolysis

The purpose of this study was to assess outcomes in Thai patients after treatment with intravenous recombinant tissue plasminogen activator (rtPA) and to determine the factors associated with good outcome and death.

Patients with acute ischemic stroke who were treated with intravenous rtPA at Thammasat University Hospital between June 2007 and April 2010 were included. The measured outcome variables were good outcome (mRS 0,1) and death at 3 months. Stepwise multivariable analyses were performed by including the prespecified factors that were associated with the measured outcome variables in the univariate analysis.

The sample size was 197 patients. At 3 months, 93 patients (47%) had good outcomes while 23 patients (12%) died within the same period. Severe stroke (OR 0.19, 95% CI 0.08-0.44, p-value <0.0001) and history of hypertension (OR 0.39, 95% CI 0.16-0.93, p-value=0.033) were independently related to bad outcome at 3 months, while receiving intravenous nicardipine (OR 2.76, 95% CI 1.09-6.94, p-value=0.032) was associated with good outcome. Severe stroke (OR 5.89, 95% CI 1.29-26.85, p-value=0.022) and pretreatment high blood glucose levels (OR 8.06, 95% CI 1.21-53.62, p-value=0.031) each were independently associated with patient death.

Standard-dose intravenous rtPA in a cohort of Thai patients led to better clinical outcomes and comparable death rates when compared to other Asian cohorts receiving intravenous rtPA. Several factors were independently associated with patient outcomes at 3 months.