Prevalence of intracerebral hemorrhage after receiving recombinant tissue-type plasminogen activator (rt-PA) in acute ischemic stroke patients at emergency departmentChaiyaphum Hospital

Abstract

This study aimed to determine the prevalence of ICH after receiving rt-PA in patients with AIS. Retrospective descriptive study, in which we reviewed the medical records of all AIS patients treated with intravenous rt-PA at at Emergency department Chaiyaphum Hospital October 1, 2016 to July 31, 2020.

             Result: ICH complications after receiving rt-PA were 10 cases (3.53%) (0.07% asymptomatic, 2.82% symptomatic), which was associated with average age of 63 years. Received antihypertensive drug before and during the administration of rt-PA 21 cases (7.42%). and the NIHSS score was mostly less than 10 with 179 cases (63.25 %). Factors associated with ICH  include The total time from symptom onset to receiving rt-PA> 180 minutes, compared with the total time from symptom onset to receiving rt-PA ≤ 180 minutes. Patients were 5.40 times more likely to develop a ICH (Adjusted Odds ratio, 5.40; 95% CI, 0.65-44.30) and patients with an INR ratio ≥ 1 were 5.78 times more likely to develop a ICH (Adjusted Odds ratio, 5.78; 95% CI, 1.17- 28.34)

             Conclusion: Treatment of AIS by intravenous intravenous thrombolysis drug rt-PA at Chaiyaphum Hospital emergency room has been highly effective in the treatment of AIS patients. The prevalence of ICH after receiving rt-PA was 3.53%. Therefore, giving  rt-PA in AIS is a highly safe treatment . Because different risk factors are controlled For example, the average age of the drug was less than 70 years, the number of patients who received antihypertensive drug before and at the time of RT-PA was very small. And dosed in patients with a NIHSS score of less than 10 mostly.The factors associated with ICH following rt-PA administration were the total time from onset to dose> 180 minutes and INR ≥1