Factors influencing early neurological recovery in patients with acute ischemic stroke

• Main Author: Orapen Sukhavulli
• Other Authors: Siriorn Sindhu
• Language: English
• Published: Mahidol University. Mahidol University Library and Knowledge Center 2023
• Subjects: Brain > Wounds and injuries > Patients > Rehabilitation; Brain damage > Psychological aspects; Cerebrovascular disease > Patients > Rehabilitation
• Online Access: https://repository.li.mahidol.ac.th/handle/123456789/89829
• Institution: Mahidol University

Ischemic stroke is a significant worldwide cause of morbidity and mortality. The goal of therapy for acute ischemic stroke (AIS) is early neurological recovery in the brain. The purposes of this cross-sectional descriptive study were to describe the early neurological recovery in patients with acute ischemic stroke and to identify the statistical predictors of early neurological recovery at 24 hours and 3 days after admission of patients with acute ischemic stroke. A purposive random sampling was employed to recruit 220 AIS patients from 8 hospitals in the southern region of Thailand starting from January to May 2016, and analyzed using multivariate logistic regression analysis. The result revealed that moderate and severe stroke severity decreased the neurological recovery at 24 hours (OR =.095, p <.001 and OR =.126, p <.01, respectively), compared with mild stroke severity. In addition, onset time to rt-PA within 3 hours and 3.0-4.5 hours increased the neurological recovery at 24 hours (OR=22.22, P <.001 and OR =17.28, P <.01, respectively), compared with those who did not receive rt-PA treatment. Lastly, age >80 years decreased neurological recovery at 24 hours after admission (OR=.361, P <.05). For the neurological recovery at 3 days, showed that moderate and severe stroke severity decreased the neurological recovery (OR=.10, p <.001and OR =.09, p <.001, respectively), compared with mild stroke severity. The stroke patients who had onset time to rt-PA within 3 hours and within 3.0-4.5 hours increased the neurological recovery at 3 days (OR=16.95, P <.05 and OR =14.43, P<.01, respectively) compared with those who did not receive rt-PA treatment. The study showed that stroke severity and onset time to rt-PA influence early neurological recovery in AIS patients. Information about early recognition of stroke signs and symptoms should be developed to enable patients gain early access to the hospital for intravenous rt-PA treatment.