Factors Affecting Cerebral Hemorrhage after Intravenous Thrombolytic Administration in Patients with Acute Ischemic Stroke Receiving Services at Yasothon Hospital
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Abstract
Background: An intravenous thrombolytic drug in patients with acute ischemic stroke is considered an effective treatment but after the drug administration may cause major complications e.g. severe intracerebral hemorrhage. To determine factors related to intracerebral hemorrhage in patients with acute ischemic stroke receiving intravenous thrombolytic drugs, leads to close surveillance to reduce the death rate, disability rate, and complications. Patients returned to a good quality of life after treatment. Objective: To study factors affecting intracerebral hemorrhage after treatment with thrombolytic drugs in patients with acute ischemic stroke or blockage. Study style: Retrospective descriptive study Methods: This study was conducted from the medical records of patients with acute cerebral embolism receiving fibrinolytic drugs (rt-PA) at general wards and intensive care units in the internal medicine department. Yasothon Hospital from October 1, 2021 to September 30, 2022, by recording basic information Laboratory results computed tomography of the brain and was used to compare the two groups, namely the group without intracranial hemorrhage (no ICH) and the group with intracranial hemorrhage (ICH). Analyze of risk factors affecting intracerebral hemorrhage using Ordinal logistic regression statistics. Results: Among 186 patients, the no ICH bleeding group (n=149) and the ICH bleeding group (n=37) were found to be more male than female, 56.45% and 43.55%, respectively. The average age was 67.42±11.09 years. Intracerebral hemorrhage complications were found in 19.89% (Symptomatic ICH 6.45%). Risk factors included atrial fibrillation (adj. OR 10.34 [95%CI 1.89, 55.38], P=.008), first blood sugar level received ≥126 mg/dL (adj. OR 12.38 [95%CI 1.79, 85.58], P=.012) and had a high NIHSS score (NIHSS ≥ 15: (adj. OR 4.58) [95%CI 1.08, 18.32], P=.042) Conclusion: Atrial fibrillation, NIHSS score ≥ 15 and baseline glucose ≥ 126 mg/dL were factors affecting incidence of intracranial hemorrhage after intravenous thrombolytictherapy in patients with acute ischemic stroke.
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