Tóm tắt
Objectives: To describe the characteristics, time metrics, in-hospital outcomes, and associated factors in patients with acute ischemic stroke treated with intravenous alteplase 0.9 mg/kg at 19-8 Hospital.
Methods: Retrospective case series of 50 consecutive patients treated within 4.5 hours of onset from April 2022 to August 2025.
Results: The mean admission National Institutes of Health Stroke Scale (NIHSS) score was 9.6 ± 3.9. The median onset-to-door and door-to-needle times were 98.5 and 36 minutes; 79.2% were treated within 60 minutes of arrival, and door-to-needle time decreased from 50 minutes (2022) to 30 minutes (2024–2025) (p = 0.034). NIHSS decreased from 8.5 to 6 at 1 hour (p < 0.001). Among 34 patients who completed treatment, 79.4% had a modified Rankin Scale (mRS) score of 0–2 at discharge, with no symptomatic intracranial hemorrhage or death. The 16 patients transferred on the treatment day had more severe stroke (median NIHSS 12 vs 7) and 56.2% had large vessel occlusion. In univariable analysis, admission NIHSS ≥ 10 and arterial occlusion were associated with an unfavorable outcome.
Conclusions: The in-hospital workflow was fast and improved over time, whereas prehospital delay remained long. Patients who completed treatment showed early neurological improvement without symptomatic hemorrhage.
