title: Long-term outcome in stroke patients treated with IV thrombolysis.
abstract: OBJECTIVE
  Data on long-term outcome after IV thrombolysis (IVT) are sparse. Our goals were to 1) estimate annual survival, and 2) evaluate determinants for an unfavorable long-term outcome after IVT for stroke.
  
  
  METHODS
  This observational study is based on the IVT registry of the University Hospital Basel. A structured telephone interview was used to ascertain information about long-term outcome (1 year to 10 years after IVT). Primary outcome parameters were 1) death and 2) excellent outcome (modified Rankin Scale scores 0 and 1). Kaplan-Meier survival estimates were calculated. Uni- and multivariate logistic regression analyses were performed to identify variables independently determining long-term outcome.
  
  
  RESULTS
  Two hundred fifty-seven IVT-treated stroke patients were eligible for analysis. Median time of follow-up was 3.0 years (interquartile range 1.0-5.0). Probability of surviving after IVT was 76% after 1 year, 66% after 3 years, and 53% after 4 years. After a median of 3 years, 37% of patients had an excellent outcome. Independent predictors for unfavorable long-term outcome were advanced age (odds ratio [OR] 1.030, 95% confidence interval [CI] 1.002-1.060, p = 0.036), higher stroke severity (OR 1.100, 95% CI 1.012-1.196, p = 0.026), unfavorable 3-month outcome (OR 6.767, 95% CI 3.391-13.503, p < 0.001), and occurrence of epileptic seizures (OR 4.899, 95% CI 1.349-17.793, p = 0.016). Intracranial hemorrhage, comorbidity, sex, initial glucose or C-reactive protein levels, and stroke etiology did not independently influence long-term outcome.
  
  
  CONCLUSIONS
  At 3 years after IVT, approximately 1 of 3 stroke patients had an excellent outcome, and 1 of 3 had died. Epileptic seizures seem to have an unfavorable effect on long-term outcome via a mechanism that remains to be clarified.
authors: Department of Neurology, University Hospital Basel, Switzerland. gensickeh@uhbs.ch
authors: Henrik
authors: H
authors: Gensicke
authors: David J
authors: DJ
authors: Seiffge
authors: Andrea E
authors: AE
authors: Polasek
authors: Nils
authors: N
authors: Peters
authors: Leo H
authors: LH
authors: Bonati
authors: Philippe A
authors: PA
authors: Lyrer
authors: Stefan T
authors: ST
authors: Engelter
mesh_terms: D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000188:drug therapy* / Q000401:mortality; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005343:Fibrinolytic Agents