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001-es BibID:	BIBFORM050397
Első szerző:	Karlinski, Michal
Cím:	Role of preexisting disability in patients treated with intravenous thrombolysis for ischemic stroke / Michal Karlinski, Adam Kobayashi, Anna Czlonkowska, Robert Mikulik, Daniel Vaclavik, Miroslav Brozman, Viktor Švigelj, Laszlo Csiba, Klara Fekete, Janika Kõrv, Vida Demarin, Aleksandras Vilionskis, Dalius Jatuzis, Yakup Krespi, Niaz Ahmed, Nils Wahlgren, Safe Implementation of Treatments in Stroke-Eastern Europe (SITS-EAST) Investigators
Dátum:	2014
ISSN:	0039-2499
Megjegyzések:	BACKGROUND AND PURPOSE:Little is known about the effect of thrombolysis in patients with preexisting disability. Our aim was to evaluate the impact of different levels of prestroke disability on patients' profile and outcome after intravenous thrombolysis.METHODS:We analyzed the data of all stroke patients admitted between October 2003 and December 2011 that were contributed to the Safe Implementation of Treatments in Stroke-Eastern Europe (SITS-EAST) registry. Patients with no prestroke disability at all (modified Rankin Scale [mRS] score, 0) were used as a reference in multivariable logistic regression.RESULTS:Of 7250 patients, 5995 (82%) had prestroke mRS 0, 791 (11%) had prestroke mRS 1, 293 (4%) had prestroke mRS 2, and 171 (2%) had prestroke mRS ?3. Compared with patients with mRS 0, all other groups were older, had more comorbidities, and more severe neurological deficit on admission. There was no clear association between preexisting disability and the risk of symptomatic intracranial hemorrhage. Prestroke mRS 1, 2, and ?3 were associated with increased risk of death at 3 months (odds ratio, 1.3, 2.0, and 2.6, respectively) and lower chance of achieving favorable outcome (achieving mRS 0-2 or returning to the prestroke mRS; 0.80, 0.41, 0.59, respectively). Patients with mRS ?3 and 2 had similar vascular profile and favorable outcome (34% versus 29%), despite higher mortality (48% versus 39%).CONCLUSIONS:Prestroke disability does not seem to independently increase the risk of symptomatic intracranial hemorrhage after thrombolysis. Despite higher mortality, 1 in 3 previously disabled patients may return to his/her prestroke mRS. Therefore, they should not be routinely excluded from thrombolytic therapy.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban
Megjelenés:	Stroke. - 45 : 3 (2014), p. 770-775. -
További szerzők:	Kobayashi, Adam Czlonkowska, Anna Mikulík, Robert Vaclavik, Daniel Brozman, Miroslav Švigelj, Victor Csiba László (1952-) (neurológus, pszichiáter) Fekete Klára (1978-) (neurológus) Kõrv, Janika Demarin, Vida Vilionskis, Aleksandras Jatuzis, Dalius Krespi, Yakup Ahmed, Niaz Wahlgren, Nils Safe Implementation of Treatments in Stroke-Eastern Europe (SITS-EAST) Investigators
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