Henrikas Kazlauskas, Elena Bovina
The aim of the study was to identify factors that influenced autonomy of patients with acute brain infarction to whom intravenous thrombolysis had been applied. Retrograde analysis was used to investigate medical history data of 64 patients treated in Klaipėda University Hospital during the period of 2005-2014. Severity of stroke in the acute phase was evaluated using the NIH Stroke Scale (NIHSS) and patients’ autonomy three months after the onset of the disease was assessed according to the modified Rankin scale. The data was analysed using version 17.0 of the Statistical Package for the Social Sciences (SPSS). The study found no statistically significant difference in groups of patients to whom intravenous thrombolysis had been performed up to 180 min and between 181 min and 270 min, when assessing their initial neurological deficit at the time of entering the hospital and functional dependence after three months, respectively, p=0.283 and p=0.445. The period between hospitalisation and the beginning of intravenous thrombolysis (min) differed significantly among men and women: men 90.30±29.64, women 119.38±40.11 (p=0.006); whereas the difference of the time interval between the incidence and the start of thrombolysis was insignificant (p=0.372). When comparing gender differences in autonomy according to the modified Rankin scale, significantly higher number of functionally autonomous men was observed: 23(88.5%) men and 6(46.2%) women (p=0.008). In addition, when analysing different age groups, ≤65 years and >65 years, significantly higher three-month mortality in senior patients was identified (p=0.012). The analysis showed that patients’ autonomy was significantly influenced only by initial neurological deficit (stroke severity) at the beginning of the disease, constituting 14.8±3.9 points within functionally dependent group and 11.8±4.1 points in the autonomous group (p=0.027). Based on the results, the study concluded that autonomy of patients who had been treated with intravenous thrombolysis was significantly influenced by the initial neurological deficit. In comparison to women, significantly higher functional autonomy of men after three months was observed. It is necessary to reduce the period between the first symptoms of stroke and the start of intravenous thrombolytic treatment.
Keyword(s): acute brain infarction; intravenous thrombolysis; factors influencing autonomy.
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