Effects of Stroke Severity on Treatment Initiated in the Emergency Department

Year 2025, Volume: 7 Issue: 2, 354 - 360, 09.05.2025

Zülfikar Memiş , İrem Kuru , Sinem Gök , Bahar İncirci , Adem Topcu , Hüseyin Ergenç , Ayşe Özlem Çokar

https://doi.org/10.37990/medr.1620713

Abstract

Aim: Stroke severity depends on the treatments administered from the moment the patient enters the emergency department and the success of patient management. In our study, we aimed to evaluate the effect of National Institutes of Health Stroke Scale (NIHSS) scoring on intervention time and the relationship of qualitative measures with clinical outcome in patients in our stroke center.
Material and Method: The files of patients who underwent iv TPA and/or mechanical thrombectomy in the emergency department who were followed up at the stroke center between 2022 and 2023 were retrospectively reviewed. Patients were divided into 4 groups as NIHSS score 0-5, 5-10, 10-20, ≥21; 3 groups as modified Rankin Scale (MRS) score 0-2, 3-5 and 6. Mean, standard deviation, median minimum, maximum, frequency and ratio values were used in the descriptive statistics of the data. ANOVA (Tukey test), Kruskal-Wallis, Mann-Whitney u test were used in the analysis of quantitative independent data; chi-square test was used in the analysis of qualitative independent data, and fischer test was used when chi-square test conditions were not met.
Results: Symptom puncture, symptom recanalization, puncture recanalization, door imaging, door TPA, door puncture times did not differ significantly (p>0.05) between stroke severity groups. The first-pass recanalization rate was significantly (p<0.05) higher in the MRS III-IV-V group than in the MRS 0-I-II group, while the first-pass recanalization rate did not differ significantly (p>0.05) between the MRS VI group and the MRS 0-I-II, MRS III-IV-V groups. In the group with bleeding at 24 hours, TICI stage was significantly (p<0.05) lower, 3rd month MRS score was significantly (p<0.05) higher, and tan score was significantly (p<0.05) lower than the group without bleeding at 24 hours.
Conclusion: Although there is no correlation between stroke severity and emergency department quality-metrics times, recanalization success has an effect on good outcome. Instroke, the coordination and experience of all components of the neurology and emergency medicine clinics hould be good in terms of diagnosis and timing.

Keywords

Thrombectomy , stroke , iv Tpa , emergency service

Ethical Statement

This study received approval from the Clinical Studies Ethics Committee of University of Health Sciences Haseki Training And Research Hospital (Decision No: 261-2023) and was conducted in accordance with the ethical standards outlined in the Declaration of Helsinki.

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