Renal function and outcome among stroke patients treated with IV thrombolysis
2008; Lippincott Williams & Wilkins; Volume: 71; Issue: 19 Linguagem: Inglês
10.1212/01.wnl.0000338459.82173.78
ISSN1526-632X
AutoresPhilippe Lyrer, Felix Fluri, D. Gisler, Sergio Papa, Florian Hatz, Stefan T. Engelter,
Tópico(s)Cerebrovascular and Carotid Artery Diseases
ResumoRenal function has been shown to be a prognostic marker for cardiovascular events.1 We performed a databank-based analysis to investigate the prognostic value of renal function regarding functional outcome, recurrent stroke, and symptomatic intracranial hemorrhage (SICH) in stroke patients treated with IV recombinant tissue plasminogen activator (rtPA). ### Methods. All consecutive stroke patients (n = 196) treated with IV-rtPA (1998–2006) were included. IV-rtPA was used according to current guidelines.2 Baseline variables were extracted from our prospectively ascertained thrombolysis database.3 The ethics committee approved of our approach to ascertain and analyze data of all rtPA-treated stroke patients. Estimates of renal function included serum-creatinine levels and glomerular filtration rates (GFR). Creatinine was measured at admission. GFR was calculated applying the simplified Modification of Diet in Renal Disease (MDRD) formula.4 Endpoints were good (modified Rankin scale [mRS] ≤2) vs poor outcome (mRS >2, including death [cause of immediate death based on information of treating physician]), recurrent ischemic stroke at 3 months (WHO criteria), and SICH (National Institute of Neurological Disorders and Stroke trial definition). All patients had CT or MR scan (72 hours) and additional scans in case of clinical deterioration. Univariate analyses regarding good vs poor outcome were performed for creatinine, GFR, and baseline variables using Fisher exact tests or t tests. Secondly, multiple logistic regression was performed with the mRS >2 as dependent …
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