Introduction: Mild and rapidly resolving ischemic strokes (RRIS) are controversial, relative contraindications for IV thrombolysis.
Methods: A retrospective review of GWTG database was performed for a 5-hospital stroke network between 2010 and 2014. Acute ischemic stroke (AIS) patients that arrived within 4.5 hours from symptom onset and had a baseline NIHSS <=5 were included. The short-term outcome measures were ambulation status at discharge, discharge disposition, mortality, and length of stay. 29% of admission and 26% of discharge ambulatory statuses were unknown and included in the independent ambulatory groups. Discharge disposition was dichotomized as good (home or rehab) or bad (SNF, hospice, or death).
Results: Of 5133 AIS patients, 480 (44% women, 49% White, 41% Hispanic, and 5.7% Black) met inclusion criteria, of which 122 (27%) were treated with IV TPA. The average age of treated patients was 73 (range of 29-92) and not treated was 67 (range 18-100). Outcome measures were not significantly different between groups (Table 1).
Discussion: This study did not find a significant difference in discharge outcomes for mild and RRIS patients who did or did not receive IV TPA. Our sample size may be too small to demonstrate a treatment effect. Both groups, however, had significant disability at discharge with ∼25% unable to ambulate independently and ∼15% bad discharge disposition. These findings provide further evidence that strokes with low NIHSS can be disabling.