PMID- 31963654 OWN - NLM STAT- MEDLINE DCOM- 20200724 LR - 20200724 IS - 1660-4601 (Electronic) IS - 1661-7827 (Print) IS - 1660-4601 (Linking) VI - 17 IP - 2 DP - 2020 Jan 18 TI - Risk Factors Associated with Outcomes of Recombinant Tissue Plasminogen Activator Therapy in Patients with Acute Ischemic Stroke. LID - 10.3390/ijerph17020618 [doi] LID - 618 AB - Ischemic stroke is the most common type of stroke, and early interventional treatment is associated with favorable outcomes. In the guidelines, thrombolytic therapy using recombinant tissue-type plasminogen activator (rt-PA) is recommended for eligible patients with acute ischemic stroke. However, the risk of hemorrhagic complications limits the use of rt-PA, and the risk factors for poor treatment outcomes need to be identified. To identify the risk factors associated with in-hospital poor outcomes in patients treated with rt-PA, we analyzed the electronic medical records of patients who were diagnosed with acute ischemic stroke and treated for rt-PA at Chang Gung Memorial Hospitals from 2006 to 2016. In-hospital death, intensive care unit (ICU) stay, or prolonged hospitalization were defined as unfavorable treatment outcomes. Medical history variables and laboratory test results were considered variables of interest to determine risk factors. Among 643 eligible patients, 537 (83.5%) and 106 (16.5%) patients had favorable and poor outcomes, respectively. In the multivariable analysis, risk factors associated with poor outcomes were female gender, higher stroke severity index (SSI), higher serum glucose levels, lower mean corpuscular hemoglobin concentration (MCHC), lower platelet counts, and anemia. The risk factors found in this research could help us study the treatment strategy for ischemic stroke. FAU - Tseng, Yi-Ju AU - Tseng YJ AUID- ORCID: 0000-0002-1814-5553 AD - Department of Information Management, Chang Gung University, Taoyuan 33302, Taiwan. AD - Department of Laboratory Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan. AD - Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan. FAU - Hu, Ru-Fang AU - Hu RF AD - Department of Information Management, Chang Gung University, Taoyuan 33302, Taiwan. FAU - Lee, Shin-Tyng AU - Lee ST AD - Department of Information Management, Chang Gung University, Taoyuan 33302, Taiwan. FAU - Lin, Yu-Li AU - Lin YL AD - Department of Nursing, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan. AD - Department of Nursing, Chang Gung University of Science and Technology, Taoyuan 33302, Taiwan. FAU - Hsu, Chien-Lung AU - Hsu CL AD - Department of Information Management, Chang Gung University, Taoyuan 33302, Taiwan. AD - Healthy Aging Research Center, Chang Gung University, Taoyuan 33302, Taiwan. AD - Graduate Institute of Business and Management, Chang Gung University, Taoyuan 33302, Taiwan. AD - Department of Visual Communication Design, Ming-Chi University of Technology, New Taipei City 24301, Taiwan. AD - Department of Nursing, Taoyuan Chang Gung Memorial Hospital, Taoyuan 333, Taiwan. FAU - Lin, Shih-Wei AU - Lin SW AD - Department of Information Management, Chang Gung University, Taoyuan 33302, Taiwan. AD - Department of Industrial Engineering and Management, Ming-Chi University of Technology, New Taipei City 24301, Taiwan. AD - Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan. FAU - Liou, Chia-Wei AU - Liou CW AD - Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. FAU - Lee, Jiann-Der AU - Lee JD AD - College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. AD - Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan. FAU - Peng, Tsung-I AU - Peng TI AD - College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. AD - Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung 20401, Taiwan. FAU - Lee, Tsong-Hai AU - Lee TH AD - Stroke Center and Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan 333, Taiwan. AD - College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20200118 PL - Switzerland TA - Int J Environ Res Public Health JT - International journal of environmental research and public health JID - 101238455 RN - 0 (Fibrinolytic Agents) RN - EC 3.4.21.68 (Tissue Plasminogen Activator) SB - IM MH - Acute Disease/epidemiology/therapy MH - Aged MH - Brain Ischemia/*epidemiology/therapy MH - Female MH - Fibrinolytic Agents/*therapeutic use MH - Humans MH - Male MH - Middle Aged MH - Risk Factors MH - Stroke/*epidemiology/therapy MH - Taiwan/epidemiology MH - Thrombolytic Therapy/*statistics & numerical data MH - Tissue Plasminogen Activator/*therapeutic use MH - Treatment Outcome PMC - PMC7014350 OTO - NOTNLM OT - ischemic stroke OT - outcome analysis OT - risk factor OT - rt-PA OT - thrombolytic therapy COIS- The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results. EDAT- 2020/01/23 06:00 MHDA- 2020/07/25 06:00 PMCR- 2020/01/01 CRDT- 2020/01/23 06:00 PHST- 2019/11/15 00:00 [received] PHST- 2020/01/07 00:00 [revised] PHST- 2020/01/15 00:00 [accepted] PHST- 2020/01/23 06:00 [entrez] PHST- 2020/01/23 06:00 [pubmed] PHST- 2020/07/25 06:00 [medline] PHST- 2020/01/01 00:00 [pmc-release] AID - ijerph17020618 [pii] AID - ijerph-17-00618 [pii] AID - 10.3390/ijerph17020618 [doi] PST - epublish SO - Int J Environ Res Public Health. 2020 Jan 18;17(2):618. doi: 10.3390/ijerph17020618.