ABSTRACT NUMBER: ESOC2026A840 CLINICAL AND PARACLINICAL PREDICTORS OF POOR FUNCTIONAL RECOVERY AFTER INTRAVENOUS THROMBOLYSIS IN PATIENTS WITH ACUTE ISCHEMIC STROKE

Abstract Background and aims Intravenous thrombolysis (IVT) represents a standard reperfusion therapy for acute ischemic stroke; however, functional outcomes at 3 months remain variable. Identification of independent predictors of unfavorable outcome may support early prognostic stratification and clinical decision-making. Aim To identify clinical and biochemical factors independently associated with unfavorable functional outcome at 3 months following IVT. Methods A retrospective observational study was conducted including 79 patients treated with IVT during 2024. Functional outcome was assessed at 3 months using the modified Rankin Scale (mRS), with unfavorable outcome defined as mRS 3-6. Univariate logistic regression was performed to explore potential predictors, followed by multivariable logistic regression including variables with statistical significance. Statistical analyses were carried out using R software (version 4.4.2). Results Unfavorable functional outcome was observed in 44 patients (56%). Sex, atrial fibrillation, and onset-to-needle time were not significantly associated with outcome (all p>0.05). No significant associations were found for leukocyte count, neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio, platelet-to-lymphocyte ratio, mean platelet volume, platelet distribution width, or erythrocyte sedimentation rate. Multivariable analysis identified baseline NIHSS score (OR=1.42; 95% CI: 1.18–1.61; p<0.001), age (OR=1.08; 95% CI: 1.04–1.16; p=0.017), and admission systolic blood pressure (OR=1.03; 95% CI: 1.01–1.04; p=0.003) as independent predictors of unfavorable outcome. Optimal cut-off values were NIHSS ≥8, age ≥65 years, and systolic blood pressure ≥177 mmHg. Conclusions Higher baseline stroke severity, advanced age and elevated admission systolic blood pressure independently predicted unfavorable functional outcome at 3 months after IVT, while laboratory indices did not add prognostic value in this cohort. Conflict of interest This study was funded by the National Agency for Research and Development (NARD) of the Republic of Moldova, research project no. 25.80012.8007.09TC.