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Intravenous thrombolysis and three-year ischemic stroke mortality.

K Chwojnicki1, G Kozera1,2, P Sobolewski3

  • 1Department of Neurology, Medical University of Gdańsk, Gdańsk, Poland.

Acta Neurologica Scandinavica
|June 24, 2016
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Summary

Intravenous thrombolysis (IVT) for ischemic stroke (IS) improves three-year survival. Key predictors of long-term mortality include older age and stroke severity, not IVT itself.

Keywords:
ischemic strokelong-term survivalthrombolysis

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Area of Science:

  • Neurology
  • Cardiovascular Medicine
  • Public Health

Background:

  • Intravenous thrombolysis (IVT) is a critical treatment for ischemic stroke (IS).
  • While IVT's effect on short-term mortality is known, its impact on long-term survival remains less clear.
  • Understanding long-term outcomes is crucial for optimizing stroke care.

Purpose of the Study:

  • To compare three-year mortality rates in IS patients treated with IVT versus those not treated.
  • To identify predictors of long-term mortality after IVT for IS.

Main Methods:

  • A cohort of 366 IS patients was analyzed from the Pomeranian Stroke Register.
  • 196 patients received IVT, while 170 matched controls did not.
  • Three-year survival and its determinants were estimated using statistical models.

Main Results:

  • IVT was not significantly associated with three-month mortality in univariate analysis.
  • Independent predictors of unfavorable long-term outcome included older age, parenchymal hemorrhage type 2, and higher modified Rankin Scale scores at discharge.
  • IVT demonstrated a strong association with a reduced risk of death within 36 months post-IS.

Conclusions:

  • Treatment of IS with intravenous recombinant tissue plasminogen activator is associated with improved three-year survival.
  • Age and stroke severity are key factors influencing long-term outcomes after IS.