Evaluation of Intravenous Thrombolytic Therapy on Acute Ischemic Stroke Outcome: A Single-center Observation Prospective Cohort Study

Background: Intravenous thrombolysis (IVT) is a standard treatment for acute ischemic stroke (AIS). We started IVT about 4 years ago (since 2017) in our center. Objectives: The aim of the thrombolysis outcome in ischemic stroke study was to confirm whether the efficacy and safety of IVT recognized in published studies could be reproduced in routine clinical practice in Iran. Materials and Methods: This study was a prospective observational cohort study on consecutive patients diagnosed with AIS, who received IVT from January 2017 to March 2019 (ClinicalTrials registration: NCT04309357). The primary outcome was the rate of functional independence at 3 months, defined as the Barthel Index (BI) 85–100. Binary outcomes included independence compared with disability or death. The secondary outcome was the rate of fatal and symptomatic intracerebral hemorrhage. Results: Out of 214 patients registered in this study, 59.34% were male and the median (interquartile range) age of patients was 69 (61–78) years. Pretreatment median scores of the modified Rankin Scale (mRS) and National Institutes of Health Stroke Scale were 3 and 10, respectively. At discharge time, 40.65% of patients achieved good outcomes. Follow-up within 3 months, 43.45% achieved BI 85–100, and 44.72% had an mRS score 0–2. The rate of all types of intracranial hemorrhages was 19.6%, of which 9.3% were symptomatic. In addition, the mortality rate during the 3 months was 17.28%. Conclusions: In our study, the efficacy of IVT was reasonable compared to international data. However, to increase efficiency, poststroke rehabilitation programs need to be organized and promoted.