22. European Stroke Conference 556 Acute stroke: emergency management, stroke units and complications THROMBOLYTIC THERAPY OF CEREBRAL INFRCTION IN ACUTE PERIOD Y.G. Bitus1, A.S. Fedulov2, T.V. Lurye3 Belorussian State Medical University, Minsk, BELARUS1, Belorussian State Medical University, Minsk, BELARUS2, Belorussian State Medical University, Minsk, BELARUS3 Introduction. Thrombolytic therapy (TLT) is the most effective method of reperfusion therapy in ischemic stroke, considerably increasing the number of patients with good functional restoration ob-tained. The present study demonstrates high efficiency of systemic TLT of patients presenting with ischemic stroke. Materials and methods. The research was carried out by analyzing the information, which was get from medical cards of the patients, who had been treated in the neurological depart-ment in the 9th Minsk hospital since February, 2008 to February, 2012 (30 patients in total).Results. The average age was 62,0 ± 9,9 years. The average score by the NIHSS score at the time of admis-sion was 16,1 ± 3,6 points. Time from the stroke onset to the admission in the middle reaches 59,7 ± 19,8 min. The so-called time from “door-to-needle” was 10-107 min (the average time - 59,1 ± 29,3 min). In the end of the thrombolytic therapy positive dynamics of neurological deficit was observed in 80% (24 patients) of cases, negative – 20% (6 patients) (pic.1): the average score at the admission by NIHSS - 16,3 ± 3,5, the seventh day - 7,9 ± 6,7 ( 8.4 points less than in baseline) (p <0.05). 3 patients have recovered completely (13%).Slight defect – 33%, moderate defect – 21%, severe de-fect – 33%. The lack of positive dynamics was observed in 2 patients (6.67%). There weren’t such complications as intracranial hemorrhage, allergic reactions.Conclusion. 1. Thrombolytic therapy is the most effective method of treatment of ischemic stroke. Regression of neurological defect was observed in 80% of cases. 13% of these patients have recovered completely. 2. Lack of regression of neurological deficit in 6.67% of cases can be explained by thrombosis more than 1/3 of the middle cerebral artery (MCA) (volume of the lesion more than 1/3 MCA is a contraindication for the TLT). It is not possible to identify this contraindication without СТА. 638 © 2013 S. Karger AG, Basel Scientific Programme 557 Acute stroke: emergency management, stroke units and complications COMMON POST-STROKE COMPLICATIONS DURING THE FIRST 90 DAYS: HOW FREQUENT ARE THEY? HOW DO THEY IMPACT FUNCTIONAL OUTCOME? G. Rohweder1, H. Ellekjær2, Ø. Salvesen3, E. Naalsund4, B. Indredavik5 Stroke Unit, St. Olav’s University Hospital, Trondheim, NORWAY1, Stroke Unit, St. Olav’s Uni-versity Hospital, Trondheim, NORWAY2, Unit for Applied Clinical Research, NTNU, Trondheim, NORWAY3, Stroke Unit, St. Olav’s University Hospital, Trondheim, NORWAY4, Stroke Unit, St. Olav’s University Hospital, Trondheim, NORWAY5 Background: This study aims to record the frequency of complications during the first 3 months in stroke patients treated in a stroke unit and followed by an early supported discharge service and to evaluate the impact of the complications on functional outcome. Methods: Patients consecutively admitted to our stroke unit within 24 hours of stroke onset were included and assessed for 16 predefined complications, daily while admitted and weekly after discharge. Func-tional outcome was assessed by modified Rankin Scale (mRS) at 90 days. Only complications oc-curring at a level of 5 % or more over the entire 3 month period were analysed for their significance applying univariate analysis with mRS day90 as the dependent variable. Multivariate analysis cor-rected for age, pre-stroke mRS and Scandinavian stroke scale (SSS) day1. Results: 244 patients were included with a mean age of 77 years (SD 9.8). 56% were female. The mean mRS was 1.71 (SD 2.9) pre-stroke and 3,47 (SD1.3) day 1. Mean SSS day1 was 40.3 (SD 16.6). 82 % of patients had one or more of the following 7 complications occurring with >/= 5% frequen-cy: Urinary tract infection (UTI) in 28%, chest infection 17%, other infection 13%, recurrent stroke 5%, acute myocardial infarction (MI) 7%, falls 29% and pain in 57% of patients. Functional outcome as assessed by mRSday90 was negatively affected by the following complica-tions with Odds Ratio (95% confidence interval): chest infections 1.36 (0.96-1.91), other systemic infections 1.71 (1.23-2.39), recurrent stroke 7.9 (3.1-20.6) and falls 1.35 (1.10-1.66). The presence of UTI, MI and pain had no impact on mRS day90. Conclusion: Four out of five patients had at least one post-stroke complication. Of the 7 complications occurring >/= 5%, chest and systemic infections, stroke recurrence and falls have a negative impact on func-tional outcome at 90 days. The occurrences of UTI, MI and post-stroke pain do not appear to influ-ence functional outcome.
Karger_ESC London_2013
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