(713) Clinical Outcomes for Ischemic Stroke Patients Treated With TPA: A Retrospective Six-Year Analysis

Introduction: Ischemic stroke is a major cause of disability and death worldwide, where the timely administration of Tissue Plasminogen Activator (tPA) is crucial for improving patient outcomes. This study investigates the yearly trends and statistical analysis of clinical outcomes for ischemic stroke patients treated with tPA at a single hospital from 2017 to 2023. The focus is on key variables such as door-to-needle time, NIH Stroke Scale (NIHSS) scores, Modified Rankin Scale (mRS) at 30 days, length of stay (LOS), and the incidence of hemorrhagic conversion.

Methods: This retrospective study included all patients who received tPA for ischemic stroke during the specified period. Data analyzed included patient age, gender, door-to-needle time, NIHSS score on presentation, LOS, mRS at 30 days, and incidence of hemorrhagic conversion. ANOVA was used for continuous variables to assess yearly changes, while Mann-Whitney U tests were applied for pairwise comparisons of ordinal outcomes like NIHSS and mRS scores.

Results: The study analyzed data from 72 patients. The mean age ranged from 65.4 to 78.9 years. The average door-to-needle time increased from 69 minutes in 2017 to 96.8 minutes in 2023, though this change was not statistically significant (F(6, 65) = 1.29, p = 0.275). The LOS varied with the highest mean observed in 2020 (11.2 days), with no significant changes across the years (F(6, 65) = 0.57, p = 0.750). Hemorrhagic conversion rates showed no significant yearly variation (χ²(12) = 12.24, p = 0.426). The Mann-Whitney U test for NIHSS scores revealed no significant differences between years (all p > 0.05). Similarly, the Mann-Whitney U test for mRS scores indicated no significant differences between years (all p > 0.05).

Conclusions: The analysis showed no statistically significant changes in door-to-needle times, patient age, LOS, NIHSS, mRS outcomes, or hemorrhagic conversion rates across the years. The findings suggest that there were no significant deteriorations in the clinical outcomes of ischemic stroke patients receiving tPA treatment at the hospital over the study period.