{'fraction_non_alphanumeric': 0.0390625, 'fraction_numerical': 0.038461538461538464, 'mean_word_length': 4.989208633093525, 'pattern_counts': {'":': 0, '<': 2, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Intravenous Thrombolysis Attenuates Neurologic Deterioration After Ischemic Stroke

Introduction Although intravenous tissue plasminogen activator (IV tPA) is associated with neurologic deterioration (ND) caused by hemorrhage, whether it attenuates deterioration as a result of other etiologies including progressive stroke remains unexplored. The objective of this study was to determine whether IV tPA is associated with a reduced risk of ND caused by progressive stroke. Methods A retrospective investigation of consecutively admitted patients with acute ischemic stroke (July 2008–June 2014) within 4.5 hours of symptom onset was conducted at a tertiary care center. Patients treated with IV tPA were compared with those who were not. The primary outcome was ND resulting from progressive infarction (a two-point increase in the National Institutes of Health Stroke Scale score during a 24-hour period). Results A total of 699 registry patients (median age 65 years, interquartile range 55–76, 48.4% women, 70.4% nonwhite) were included in the study, and 58.1% received IV tPA. In crude regression, IV tPA did not reduce the odds of ND caused by progressive infarction; however, IV tPA–treated patients were at a 55% lower odds of ND from any cause (odds ratio 0.45, 95% confidence interval 0.32–0.61, P < 0.001). After adjusting for covariates, IV tPA use remained strongly associated with a 39% lower odds of ND from any cause (odds ratio 0.61, 95% confidence interval 0.48–0.79, P < 0.001). Conclusions Although IV tPA did not correlate with a reduced odds of progressive infarction, it was significantly associated with a lower odds of ND by any mechanism.