ABSTRACT NUMBER: ESOC2026A1576 INTRAVENOUS THROMBOLYSIS IN ACUTE ISCHEMIC STROKE: 2025 STATISTICAL ANALYSIS IN NEUROLOGY DEPARTMENT OF ”CAROL DAVILA” CENTRAL MILITARY EMERGENCY UNIVERSITY HOSPITAL

Abstract Background and aims Intravenous thrombolysis (IVT) is a cornerstone reperfusion therapy for acute ischemic stroke, with outcomes closely dependent on treatment timeliness. This study aimed to evaluate IVT outcomes and to identify system-related factors influencing treatment delays and early prognosis. Methods We conducted a retrospective analysis of consecutive patients with acute ischemic stroke treated with IVT between January and December 2025. Collected data included demographic characteristics, symptom-to-door time, and door-to-needle time. Stroke severity and early outcomes were assessed using ASPECTS and the National Institutes of Health Stroke Scale (NIHSS) at 24 hours and 7 days. Additional outcomes included early survival, neurological evolution, haemorrhagic transformation, length of hospital stay, and estimated hospitalisation costs. Results Among 497 patients admitted with acute ischemic stroke, 35 patients (7%) received IVT. The most represented age group was 71–80 years, and 58% were female. Mean symptom-to-door time was 195 minutes, while mean door-to-needle time was 65 minutes. The average hospital stay was 13 days, with a mean estimated hospitalisation cost of 2091 EUR per patient. Early in-hospital survival within 15 days was 65–70%, while 15% of patients died. At day 7, significant neurological improvement, defined as a ≥4-point NIHSS reduction, was observed in 46% of patients, whereas 20% experienced neurological deterioration. Conclusions Although IVT was administered to a limited proportion of stroke patients, it was associated with meaningful neurological improvement in nearly half of treated cases and survival. Persistent pre-hospital delays, in-hospital organisational constraints, and substantial treatment costs highlight the need for system-level optimisation to improve outcomes and cost-effectiveness. Conflict of interest Iacob Andreea-Elena. Nothing to disclose; Plesa Cristina. Nothing to disclose;Trandafir Maria-Teodora. Nothing to disclose; Georgescu Ioana. Nothing to disclose; Sirbu Monica.Nothing to disclose;Din Alexandra Madalina.Nothing to disclose;Sirbu Carmen. Nothing to disclose.