ABSTRACT NUMBER: ESOC2026A1283 OUTCOMES OF ACUTE STROKE PATIENTS TREATED WITH RTPA: A RETROSPECTIVE STUDY AT A TERTIARY HOSPITAL

Abstract Background and aims Stroke is one of the top leading causes of disability and death in the Philippines. According to the American Heart Association (AHA), administration of recombinant tissue plasminogen activator (rTPA) to eligible patients improves outcomes in acute ischemic stroke. In this retrospective cohort study, we compared functional outcomes and complications among 196 patients receiving rTPA within 3 hours versus those treated later. Methods We collected demographic, clinical, and outcome data from a government tertiary hospital. Outcomes included pre- and post-treatment National Institute of Health Stroke Scale (NIHSS) scores and Modified Rankin Scale (mRS) at discharge, three months, and six months. We also recorded hemorrhagic conversions, in-hospital complications, and mortality. Results The majority of patients were >50 years old, and predominantly male. The most prevalent lifestyle behavior was alcoholic beverage drinking. The most common comorbidities were hypertension and diabetes mellitus. Small vessel disease was the most common TOAST classification in both groups, and anterior stroke location was more frequent. Median NIHSS scores improved in both groups (10 to 5 vs. 11 to 6). Despite significant functional gains overall, patients treated after 3 hours had a higher rate of hemorrhagic conversion and complications. The strongest predictors of mortality were parenchymal hemorrhage (PH2) (OR=30.38) and cardiac complications (OR=104.67). Conclusions Our data showed earlier rTPA administration (<3 hours) was associated with better functional recovery, while patients with higher baseline NIHSS and those treated after three hours experienced more complications. These findings reinforce the importance of rapid stroke triage and timely thrombolysis to optimize outcomes. Conflict of interest Ma. Regina D. Matabang: nothing to disclose