Factors associated with long-term prognosis after ischemic stroke treated with fibrinolytic agents

Objective. To analyze the variables associated with better functional outcome 3 months after ischemic stroke treated with fibrinolytic agents. Material and methods. The cases of 63 patients with characteristics leading to activation of a stroke code were analyzed retrospectively. The patients received fibrinolytic therapy in a referral hospital for the western district of Malaga, Spain. We recorded the time until start of fibrinolytic therapy, severity according to the National Institute of Health Stroke Scale (NIHSS) at baseline and at 24 hours, and functional outcome at 3 months according to the modified Rankin Scale. Results. Data for 63 patients with a mean (SD) age of 65 (11) years were included. The mean time until start of fibrinolytic therapy was 151 (42) minutes. The mean NIHSS scores were 15.5 (4.8) points at baseline and 9.1 (7.13) at 24 hours. The mean change in score at 24 hours was 6.3 (5.8) points. The findings of correlation analysis between scores on the modified Rankin scale and other variables were as follows: NIHSS score at 24 hours, rho = 0.73; P <.01; NIHSS at baseline, rho = 0.34; P =.01); age, rho = 0.41; P =.001); time until start of fibrinolysis, rho = 0.21; P =.09); change in NIHSS score at 24 hours, rho = 0.61; P =.001). Conclusions. The prognosis for the functional recovery of patients given intravenous fibrinolytic therapy after stroke depends on such factors as age, time treatment is started, severity, and the patient's status at 24 hours. The last factor is the one that is most strongly related to prognosis.