Assessment of intravenous thrombolytic therapy response in acute ischemic stroke using NIHSS changes and laboratory parameters

Acute ischemic stroke is one of the leading causes of morbidity and mortality in adults. Although intravenous thrombolytic therapy (IVTT) can improve neurological recovery in appropriate patients, the treatment response shows variability among individuals. Although the NIHSS score is widely used to monitor clinical response, it should be evaluated together with laboratory parameters to more accurately predict prognosis. In this study, the relationship between NIHSS score change and laboratory parameters in acute ischemic stroke patients treated with IVTT was investigated. Thirty-three acute ischemic stroke patients who presented to the emergency department in 2024 and received IVTT were retrospectively analyzed. Baseline and 24-hour NIHSS scores were recorded. Hemogram and biochemical parameters were analyzed. Clinical response was defined as a ≥ 4-point reduction in NIHSS score at 24 h after IVTT, and its associations with mortality and hemorrhagic complications were statistically evaluated. Three-month mortality was 15.2%, and the hemorrhage rate was 9.1%. Platelet levels were found to be significantly lower in patients who died. The second NIHSS score was significantly associated with mortality and hemorrhage. Serum calcium and basophil levels were associated with clinical improvement. In ROC analysis, basophil showed a relatively higher discriminative ability than calcium in predicting clinical improvement; however, these findings should be interpreted cautiously given the small sample size and the exploratory nature of the analysis.