OUTCOMES OF THROMBOLYTIC THERAPY AMONG ACUTE ISCHEMIC STROKE IN REHMAN MEDICAL INSTITUTE PESHAWAR

Abstract

Stroke is a critical neurological emergency and a leading cause of mortality and long-term disability worldwide, with ischemic stroke accounting for approximately 80–85% of cases. Rapid diagnosis and timely intervention are essential to minimize neuronal damage and improve functional outcomes. This study aimed to evaluate the outcomes of thrombolytic therapy in patients with acute ischemic stroke at Rehman Medical Institute (RMI), Peshawar. A cross-sectional observational study was conducted over six months, including 185 patients aged ≥18 years who received intravenous thrombolytic therapy (alteplase). Data were collected from emergency and neurology departments using a structured questionnaire and analyzed using SPSS version 23.0. Patients with hemorrhagic stroke or those on anticoagulant therapy were excluded. Results demonstrated that 165 (89.2%) patients showed significant clinical improvement following thrombolytic therapy, while 20 (10.8%) did not improve. Male patients constituted 51.35% of the sample, and females 48.65%, with slightly higher improvement rates observed in females. Age-wise analysis revealed that patients over 60 years showed the highest proportion of improvement, though also accounted for most non-improved cases. Urban residents had better outcomes compared to rural patients. The majority (73.5%) received treatment in the emergency department, where higher improvement rates were observed. Complications included intracranial hemorrhage in 9.73% and seizures in 15.14% of patients. The in-hospital mortality rate was 7%, with higher mortality among males. In conclusion, thrombolytic therapy with alteplase significantly improves outcomes in acute ischemic stroke patients when administered timely, although associated risks such as hemorrhage and seizures remain important considerations.