Preprint Article Version 1 This version is not peer-reviewed

Clinicopathological Observations in Acute Stroke Patients Treated with Intravenous Thrombolysis

Lilla Hudák
,
Kitti Bernadett Kovács
,
Zsuzsa Bagoly
,
Istvan Szegedi
,
Viktor Bencs
,
Linda Lóczi
,
Rita Orbán-Kálmándi
,
Henrietta Péter-Pakó
,
Zsófia Fülesdi
,
Blanka Busi
,
Attila Nagy
,
Beáta Perjési-Kiss
,
László Oláh
,
László Csiba
*
Version 1 : Received: 15 August 2024 / Approved: 16 August 2024 / Online: 16 August 2024 (05:53:45 CEST)

How to cite: Hudák, L.; Kovács, K. B.; Bagoly, Z.; Szegedi, I.; Bencs, V.; Lóczi, L.; Orbán-Kálmándi, R.; Péter-Pakó, H.; Fülesdi, Z.; Busi, B.; Nagy, A.; Perjési-Kiss, B.; Oláh, L.; Csiba, L. Clinicopathological Observations in Acute Stroke Patients Treated with Intravenous Thrombolysis. Preprints 2024, 2024081204. https://doi.org/10.20944/preprints202408.1204.v1 Hudák, L.; Kovács, K. B.; Bagoly, Z.; Szegedi, I.; Bencs, V.; Lóczi, L.; Orbán-Kálmándi, R.; Péter-Pakó, H.; Fülesdi, Z.; Busi, B.; Nagy, A.; Perjési-Kiss, B.; Oláh, L.; Csiba, L. Clinicopathological Observations in Acute Stroke Patients Treated with Intravenous Thrombolysis. Preprints 2024, 2024081204. https://doi.org/10.20944/preprints202408.1204.v1

Abstract

Ischemic stroke is a leading cause of mortality worldwide, and intravenous thrombo-lysis, while improving functional outcomes, still leaves a significant mortality rate. This study aimed to investigate the clinical and pathological data of thrombolysed stroke patients who subsequently died and underwent autopsy, focusing on hemorrhagic transformation (HT). Over a 10-year period, 1426 acute ischemic stroke patients re-ceived thrombolysis at our center, with an in-hospital mortality rate of 11.7%. Autop-sies were performed on 98 of the 167 deceased patients. HT was found in 47% of these cases, only less than half occurring within a day of thrombolysis. Significant inde-pendent predictors of HT included higher lactate dehydrogenase (LD) levels and higher INR values at admission. HT directly caused death in 30% of cases, often through herniation, while other complications (pulmonary embolism, pneumonia) were also common. These findings underscore the importance of postmortem investi-gations to accurately determine the incidence of HT and contributing factors. Our data indicate that in the vast majority of HT cases, the role of contributing factors other than rt-PA may be important. Of the routinely assessed clinical and laboratory parameters at admission only LD and INR were found to be independent predictors of HT in the autopsied studied cohort.

Keywords

ischemic stroke; autopsy; hemorrhagic transformation

Subject

Medicine and Pharmacology, Neuroscience and Neurology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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