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Título:	The Outcome of Patients with Mild Stroke Improves after Treatment with Systemic Thrombolysis
Autor/a:	Urra, Xabier; Ariño, Helena; Llull, Laura; Amaro, Sergio; Obach, Víctor; Cervera Álvarez, Álvaro; Chamorro Sánchez, Ángel
Notas:	Introduction: In up to one third of patients with mild stroke suitable to receive systemic thrombolysis the treatment is not administered because the treating physicians estimate a good spontaneous recovery. However, it is not settled whether the fate of these patients is equivalent to those who are thrombolysed. Methods: We analyzed 203 consecutive patients (134 men and 69 women, mean age 69614 years) without premorbid disability and a NIHSS score #5 at admission [median 3 (IQR 2-4)]. Intravenous thrombolysis was administered within 4.5 hours from stroke onset (n = 119), or it was withheld (n = 84) whenever the treating physician predicted a spontaneous recovery. The baseline risk factors, clinical course, infarction volume, bleeding complications, and functional outcome at 3 months were analyzed and declared to a Web-based registry which was accessible to the local Health Authorities. Results: Expectedly, not thrombolysed patients had the mildest strokes at admission [median 2 (IQR 1-3.75)]. At day 2 to 5, the infarct volume on DWI-MRI was similar in both groups. There were no symptomatic cerebral bleedings in the study. An ordinal regression model adjusted for baseline stroke severity showed that thrombolysis was associated with a greater proportion of patients who shifted down on the modified Rankin Scale score at 3 months (OR 2.66; 95% CI 1.49-4.74, p = 0.001). Conclusions: Intravenous thrombolysis seems to be safe in patients with mild stroke and may be associated with improved outcome compared with untreated patients. These results sup
Materia(s):	-Isquèmia cerebral -Malalties cerebrovasculars -Hemorràgia -Cerebral ischemia -Cerebrovascular disease -Hemorrhage
Derechos:	cc-by (c) Urra, Xabier et al., 2013 http://creativecommons.org/licenses/by/3.0/es
Tipo de documento:	Artículo Artículo - Versión publicada
Editor:	Public Library of Science (PLoS)
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