KẾT QUẢ ĐIỀU TRỊ TIÊU SỢI HUYẾT BẰNG ALTEPLASE VÀ CÁC YẾU TỐ TIÊN LƯỢNG Ở BỆNH NHÂN CAO TUỔI NHỒI MÁU NÃO CẤP TẠI BỆNH VIỆN HỮU NGHỊ ĐA KHOA NGHỆ AN

Abstract

Objective: To describe the clinical and paraclinical characteristics as well as risk factors in elderly patients with acute ischemic stroke treated with intravenous Alteplase at Nghe An General Friendship Hospital. Subjects and Methods: A prospective descriptive study was conducted on 50 elderly patients with acute ischemic stroke who received Alteplase treatment at Nghe An General Friendship Hospital from July 15, 2024 to March 31, 2025. Results: The male-to-female ratio was approximately 1:1, with a mean age of 72.38 ± 9.07 years. Common risk factors included hypertension (80%), dyslipidemia (26%), diabetes mellitus (24%), atrial fibrillation (16%), and smoking (20%). The mean onset-to-door time was 142 ± 48.7 minutes. The proportion of patients with a favorable clinical outcome (mRS 0–2) at discharge and at 90 days was 52% and 64%, respectively. Patients aged 60–79 years had a good neurological recovery rate at discharge of 50%, which was 10 times higher than in patients aged ≥80 years (2%) (p = 0.021). Patients with an initial NIHSS score <10 were 3.6 times more likely to achieve a discharge mRS ≤2 compared to those with NIHSS ≥10 (p = 0.044). Conclusions: Advanced age and comorbidities such as hypertension, diabetes mellitus, dyslipidemia, and atrial fibrillation increase the risk of acute ischemic stroke. Most patients treated with thrombolysis had favorable clinical outcomes, and no in-hospital mortality was recorded. An initial NIHSS score <10 and ASPECTS score 9–10 were significant predictors of favorable outcomes at discharge and at 90 days post-thrombolysis.