Premium
Intravenous thrombolysis and three‐year ischemic stroke mortality
Author(s) -
Chwojnicki K.,
Kozera G.,
Sobolewski P.,
Fryze W.,
Nyka W. M.
Publication year - 2017
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12625
Subject(s) - medicine , thrombolysis , modified rankin scale , proportional hazards model , stroke (engine) , univariate analysis , survival analysis , surgery , tissue plasminogen activator , ischemic stroke , cardiology , ischemia , multivariate analysis , myocardial infarction , mechanical engineering , engineering
Background and Purpose Intravenous thrombolysis ( IVT ) in ischemic stroke ( IS ) does not reduce three‐month mortality; however, longer‐term survival after IVT has not been clearly established. Thus, we aimed to compare three‐year mortality after IS in IVT ‐treated vs non‐treated patients and to indicate predictors of long‐term mortality after IVT . Methods We have evaluated data of 366 subjects with IS (196 treated with IVT and 170 non‐treated with IVT , whose age, sex, and calendar time of IS occurrence matched the control group) collected via the Pomeranian Stroke Register. We estimated the three‐year survival and its determinants in both groups. Results In univariate analysis, IVT was not associated with three‐year mortality ( OR 0.68; 95% CI 0.44–1.05). Independent predictors for unfavorable long‐term outcome in a Cox regression model were older age, parenchymal hemorrhage type 2 (ph2), and modified Rankin scale >2 points at discharge from the hospital. IVT was strongly associated with a lower risk of death in the period 0–36 months from IS ( HR 0.44, 95% CI 0.28–0.69, P <.001). Conclusions Treatment of IS with intravenous recombinant tissue plasminogen activator was associated with increased survival during the three‐year follow‐up.