London, United Kingdom 2013 Poster Session Red Cerebrovasc Dis 2013; 35 (suppl 3)1-854 281 8 Acute stroke: current treatment Administration of IV Fluids in Acute Ischemic Stroke M. Mercado1, H. Lau2, C.S. Kase3, T. Nguyen4 Boston University Medical Center, Boston, USA1, Boston University Medical Center, Boston, USA2, Boston University Medical Center, Boston, USA3, Boston University Medical Center, Bos-ton, USA4 INTRODUCTION: Stroke is the leading cause of disability in the United States and the third lead-ing cause of death. Although included in acute stroke guidelines, the benefits of IV fluid administra-tion have not been studied. Our aim was to determine whether the administration of IV fluids in the emergency setting improves neurological outcome. METHODS: In this retrospective cohort study, we included 470 acute ischemic stroke patients who presented to the emergency room and were evaluated acutely by a neurologist. Patients were in-cluded if confirmed to have stroke on either DWI MRI or CT, and excluded if they received other interventions such as IV alteplase, endovascular therapies, or neuro/vascular surgery. Admission and discharge NIHSS were recorded, and patients were divided into those who received 1L or more of IV fluids in the emergency room and those who did not. RESULTS: Of 470 patients, 99 (21%) had IV fluids administered, and 371 (79%) did not. Mean NI-HSS change in patients who had IV fluids was -2.64+/-3.85 (median -2), and -1.47+/-3.25 (median -1) in those who did not (p=0.0024, 95% CI 0.42 to 1.92). Baseline characteristics including age, sex, admission NIHSS, emergency room SBP, length of hospital stay, presence of cardiomyopa-thy, and admission creatinine showed no statistically significant difference between the two groups. Twenty-seven percent of patients in the IVF group experienced a decrease in NIHSS >3, compared to 16% in the no IVF group (RR = 1.68, p = 0.0115, CI 1.13-2.51; NNT = 9). CONCLUSION: In this retrospective cohort study, the administration of IV fluids in the emergency room setting resulted in improved neurological outcome by NIHSS change between admission and discharge. Further randomized studies of IV fluid administration for acute ischemic stroke should be conducted to determine the potential benefits of this accessible treatment. 9 Acute stroke: current treatment ACUTE ISCHEMIC STROKE PATIENTS WITH DIABETES SHOULD NOT BE EXCLUD-ED FROM INTRAVENOUS THROMBOLYSIS. B. FUENTES1, A. CRUZ HERRANZ2, P. MARTÍNEZ-SÁNCHEZ3, A. RODRÍGUEZ-SANZ4, G. RUIZ-ARES5, D. PREFASI6, B.E. SANZ-CUESTA7, E. DÍEZ-TEJEDOR8 LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTITUTE, MADRID, SPAIN1, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTITUTE, MA-DRID, SPAIN2, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTITUTE, MADRID, SPAIN3, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTI-TUTE, MADRID, SPAIN4, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTITUTE, MADRID, SPAIN5, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RE-SEARCH INSTITUTE, MADRID, SPAIN6, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTITUTE, MADRID, SPAIN7, LA PAZ UNIVERSITY HOSPITAL. IDIPAZ HEALTH RESEARCH INSTITUTE, MADRID, SPAIN8 Background: Despite that almost one-third of stroke patients have DM, and that DM itself is not a contraindication for intravenous thrombolysis (IVT), it has been reported a lower use of this therapy in ischemic stroke patients with DM, that may reflect physician concerns regarding the risk of poor outcomes related to DM. Aim: to analyze whether there exist any differences in stroke outcomes after IVT-treatment between patients with or without DM. Methods: Observational study with inclu-sion of ischemic stroke patients between 2006-2010 admited to an acute Stroke Unit. Demographic data, vascular risk factors, comorbidity (Charlson Index), stroke severity (NIHSS) and 3-months follow-up outcome (modified Rankin Score) were compared between IVT-treated acute ischemic stroke patients according to prior diagnosis of DM. Results: 1139 acute stroke patients were admit-ted, 283 (24.8%) had a prior diagnosis of DM. 261 patients were IVT-treated (23.2% of the non DM group and 21.9% of the DM group). DM Patients were older (70.8 vs. 66.7 y p=0.029), had high-er frequency of hypertension (85.5% vs 55.8%; P<0.05), used more frecuently prestroke diuretics (32.3% vs. 17.9%; P>0.005) and statins (38.7% vs. 23.9%; P<0.05), had more comorbidity (Charl-son Index ≥ 2; 26.1% vs. 4.3%; P<0.05) and higher glycaemia on admission (161 mg/dl vs. 114 mg/ dl; P<0,01) than non DM patients. There were no significant differences in stroke severity (median NIHSS 8 vs. 8), development of any grade of hemorhagic transformation evaluated at the 24-36 h cranial CT (12.9% in the DM group vs. 8.2% in the non DM group; P=0.310), in-hospital mortality (12.9% vs. 6.1%; P=0.101) neither than in stroke outcome (ERm ≤2: 60.9% vs. 67.1%; P=0.481). Conclusions: Acute ischemic stroke patients with DM get similar benefit from IVT than those with-out DM, despite being older and having higher comorbidity. Thus, they should not be excluded from intravenous thrombolytic therapy only on the basis of DM diagnosis.
Karger_ESC London_2013
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