Intravenous thrombolysis in acute ischemic stroke: A prospective cross-sectional observational study in Kashmir

Background: Till date, no data has been published about the use of intravenous (IV) thrombolysis in acute ischemic stroke (AIS) from Kashmir valley. Objective: The objective of the study is to assess and determine the pattern of use of IV thrombolysis for AIS in Kashmir, including its efficacy and the difficulties faced in providing this modality of treatment. Materials and Methods: This was a prospective cross-sectional observational study conducted from July 2016 to July 2018. All those patients who were admitted with a diagnosis of stroke and gave informed consent were included in this study. Results: A total of 2023 patients of stroke presented to our emergency department during the study period. Out of them, 1085 (53.6%) cases were found to have hemorrhagic stroke and 938 (46.3%) patients were having ischemic stroke. 9.2% patients of ischemic stroke presented within the window period of thrombolysis, but only 34 (3.6%) patients received IV alteplase. The mean onset to door time in those who received thrombolysis was 103.5 ± 51.17 min. Door-to-needle time (DNT) of ≤60 min was achieved in only 14 (41.2%) cases, whereas mean DNT was 82.7 ± 49.17. There was a statistically significant improvement in the National Institutes of Health Stroke Scale in those who received thrombolysis as compared to those who did not receive it. Conclusion: Hemorrhagic stroke occurs in majority of stroke patients (53.6%) in our community. 3.6% of ischemic stroke patients were thrombolyzed. Thrombolytic therapy presented positive outcomes in comparison to nonthrombolyzed patients which, however, was not statistically significant.