Impact of Thrombolytic Therapy on Stroke Severity, Complications, Disability and Quality of Life in Ischemic Stroke Patients
Year: 2026
Type: article
Study design: Observational Study
Abstract: Background: Ischemic stroke is a major public health burden globally and in Iraq, often leading to long-term disability and poor quality of life. Thrombolytic therapy with recombinant tissue Plasminogen Activator (rtPA) has been shown to improve acute and long-term outcomes in eligible patients, yet its real-world impact remains underexplored in low-resource settings such as the Kurdistan Region. Objective: To evaluate the impact of thrombolytic therapy on stroke severity, in-hospital complications, functional disability and Quality of Life (QoL) in ischemic stroke patients compared to those receiving usual care. Methods: A comparative cross-sectional study was conducted among 60 ischemic stroke patients admitted to Shar Hospital in Sulaymaniyah. Thirty patients received intravenous thrombolysis with rtPA within the recommended time window, while 30 matched patients were managed with usual care. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) at admission, discharge and three months post-stroke. Disability was evaluated using the modified Rankin Scale (mRS) at admission and three months post-stroke and quality of life was assessed with the Stroke-Specific Quality of Life Scale (SS-QoL) at three months post-stroke. Complications were documented during hospitalization. Results: There was no significant difference in initial NIHSS scores between groups (p = 0.938), confirming baseline comparability. However, thrombolysis significantly reduced stroke severity at discharge (p = 0.001) and at three months (p = 0.004). A greater proportion of patients in the thrombolysis group achieved favorable functional outcomes (mRS ≤2) and reported good QoL (66.7%) compared to the control group (16.7%, p = 0.001). Additionally, thrombolysis was associated with fewer in-hospital complications (p = 0.018). The thrombolysis group also scored significantly higher across multiple QoL domains, including mobility, self-care, mood and upper extremity function. Conclusion: Thrombolytic therapy significantly improves neurological recovery, functional independence and quality of life in ischemic stroke patients, while reducing complication rates. These findings highlight the urgent need to expand thrombolytic stroke care services in Iraq, particularly in underserved regions. Implementation of time-sensitive stroke pathways and public awareness campaigns may enhance treatment access and outcomes.
Institutions: Kurdistan Regional Government, University of Sulaimani
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W7124254249
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