[Intravenous thrombolysis with rt-PA in stroke: experience of the Nice stroke unit].
BACKGROUND
Intravenous thrombolysis with rt-Pa in stroke has been approved in France since 2002. We report an evaluation of our practice. We have tried to identify predictive factors of dependence and death, and to compare our results with the data of the literature.


METHODS
All patients treated with intravenous rt-PA within the first 270min after the stroke onset were included. Univariate, then multivariate analyses were performed to determine the variables influencing the functional outcome at 3 months follow-up, according to a dichotomy established from the modified Rankin scale.


RESULTS
One hundred and forty-two patients were included in this study (mean initial National Institute of Health Stroke Scale [NIHSS]: 15). Fifty percent had a Rankin score higher than 2 at 3 months follow-up. NIHSS above 12, glycemia of at least 120mg/l, and systolic blood pressure above 160mmHg at admission were identified as independent predictive factors of poor functional outcome. Less than 4 points decrease of NIHSS proved to be a simple and early predictor of poor functional outcome at 3 months follow-up.


CONCLUSIONS
In terms of safety and efficacy the data issuing from the daily activity of our stroke unit are comparable with those of clinical trials.
Suissa
L
L
Unité neurovasculaire-soins intensifs, hôpital Saint-Roch, CHU de Nice, 5, rue Pierre-Dévoluy, 06006 Nice cedex 1, France. suissa.l@chu-nice.fr <suissa.l@chu-nice.fr>
Bozzolo
E
E
Lachaud
S
S
Berthier
F
F
Mahagne
M-H
MH
D000368:Aged; D000369:Aged, 80 and over; D002986:Clinical Trials as Topic; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012449:Safety; D020521:Stroke / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator