Factor Affecting Intracranial Hemorrhage in Ischemic Stroke Patient after Receiving Intravenous rt-PA in Hua Hin Hospital
Keywords:
Ischemic stroke, Intravenous recombinant tissue plasminogen activator (IV rt-PA), Intracranial hemorrhageAbstract
Background: The incident of ischemic stroke in Thailand is increasing and leading to higher morbidity and mortality. The standard treatment of ischemic stroke onset lease than 4.5 hours is intravenous thrombolytic or IV rt-PA. The most serious complication of IV rt-PA is intracranial hemorrhage that is resulting to more disability and death of ischemic stroke patient.
Objective: This research attempts to find out factor associated with increasing risk of intracranial bleeding after receiving IV rt-PA in ischemic stroke patient at Hua Hin Hospital.
Method: This study is retrospective analytical study. The data are collected from medical records of patients who diagnosed with acute ischemic stroke and receiving IV rt-PA during the period from 1 January 2020 to 31 December 2022. The data are analyzed by Logistic regression analysis.
Results: A total number of ischemic stroke patient who receiving IV rt-PA is 84 and the incident of intracranial hemorrhage is 15 or 17.85%. The factor that we comparing are sex, age, underlying disease, atrial fibrillation, using of antiplatelet and anticoagulant, blood pressure, NIHSS score, onset to rt-PA, creatinine, blood sugar, coagulogram, platelet count. The factor associated with intracranial hemorrhage is platelet number (adj.OR 15.94, 95%CI 1.84 - 138.18, P=0.012). The factor that possibly be associated are NIHSS score more than 13 (adj.OR 3.24, 95%CI 0.86 - 12.15, P=0.082), time onset to rt-PA more than 210 min (adj.OR 2.61, 95%CI 0.68 - 10.07, P=0.164).
Conclusion: The Factor affecting intracranial hemorrhage in ischemic stroke patient after receiving intravenous rt-PA in Hua Hin Hospital is platelet level.
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