Stroke Thrombolysis in a Tertiary Care Teaching Hospital in Saudi Arabia - A Single Center Experience (P2.282)

Objective: To analyze the outcome of thrombolysis for acute ischemic stroke in a tertiary care teaching hospital in Saudi Arabia following establishment of stroke unit. Methods: Patients were identified from quality monitoring data of the stroke unit from March 2012 to July 2015. Relevant data were collected retrospectively and analyzed using SPSS V22.0. Results: A total of 59 (4.6[percnt]) patients received thrombolysis among 1292 stroke admissions. Six were excluded from analysis because proper stroke code pathway was not utilized. Thirty (56.6[percnt]) were men. Mean age was 57 (+/-14) years. Mean NIHSS score was 15 (+/-6). 33 received intravenous (IV) thrombolysis alone; 13 received intraarterial (IA); and 7 received combined IV and IA thrombolysis. Mean door-to-needle time was 93 (+/-28) minutes for IV thrombolysis; door-to-groin time was 183 (+/-65) minutes for IA thrombolysis. Twenty (38[percnt]) patients showed improvement in NIHSS of 4 points or more at 48 hours; fifteen (28[percnt]) had initial deterioration. Symptomatic intracranial hemorrhage (ICH) was seen in five (9[percnt]) patients. Total hemorrhages and asymptomatic ICH were more common in patients aged 60 and above (p=0.025 and 0.001 respectively). Stroke related complications including cerebral edema, seizures, infections, gastrostomy tube and tracheostomy requirement were significantly more common in women 16/23 (57[percnt]) than men 12/30 (43[percnt]) (p=0.033) despite similar baseline and discharge NIHSS. Discharge NIHSS in patients younger than 60 years was better than patients above 60, 4 (+/-5) versus 8 (+/-6) (p=0.047); although they had similar baseline NIHSS. Overall three months mortality was 11[percnt]. Fifteen (28[percnt]) patients were discharged with mRS 0-2; and 32 (60[percnt]) patients had mRS 3-5. Conclusions: In our newly established stroke unit, the overall mortality and discharge disposition were comparable to standards. Women had significantly more stroke related complications. Patients older than 60 years had more thrombolysis related complications and were discharged with higher NIHSS. Disclosure: Dr. Khatri has nothing to disclose. Dr. Alkhathaami has nothing to disclose. Dr. Abulaban has nothing to disclose. Dr. Alhamouieh has nothing to disclose. Dr. Scriven has nothing to disclose. Dr. Tarawneh has nothing to disclose. Dr. Alrasheed has nothing to disclose. Dr. Kojan has received personal compensation for activities with Janssen-Cilag, Merck Serono, Novartis, and Bayer Schering. Dr. Alotaibi has nothing to disclose. Dr. Al-Khalaf has nothing to disclose. Dr. Alshehri has nothing to disclose. Dr. El-Metwally has nothing to disclose.