Efficacy of intravenous thrombolysis in treating cortical and lacunar strokes: analysis from the Qatar Stroke Registry in a multi-ethnic population
Bibliographic record
Abstract
Objective: Intravenous thrombolysis is an effective method in treating acute ischaemic stroke, with several studies reporting improved outcomes and reduced mortality rates. However, there are limited data on whether thrombolysis is effective in treating different ischaemic stroke subtypes in the Middle East and North African region. Methods: Data of cortical and lacunar patients who received intravenous thrombolysis from the Qatar Stroke Registry were retrospectively analysed from April 2014 to January 2025. Patients were matched 1:2 for age and admission National Institute of Health Stroke Scale (NIHSS). Results: Patients with cortical stroke who received recombinant tissue-type plasminogen activator (rt-PA) had a significantly lower proportion of a poor clinical outcome at 90 days (modified Rankin Scale (mRS) score of 3-6; 41.5% vs 50.5%, p=0.002), significantly lower NIHSS score at discharge (NIHSS score >10: 23.0% vs 33.9%, p<0.001), significantly lower proportion of mortality at 90 days (4.7% vs 8.2%, p=0.02) and significantly shorter length of stay (5.2 days vs 6.0 days, p=0.01) compared with controls. In terms of outcomes for patients with lacunar stroke, there were no significant differences compared with controls for their mRS score at 90 days (p=0.054), NIHSS score at discharge (p=0.21), mortality at 90 days (p=0.67) and length of stay (p=0.34). A multivariate conditional logistic regression model revealed that high admission NIHSS score (>10) was a significant predictor of a poor functional outcome at 90 days for cortical stroke post rt-PA (p<0.001), whereas for lacunar stroke, both high admission NIHSS score (>10) and symptom onset of >3 hours were identified as significant predictors of a poor functional outcome at 90 days post rt-PA (p=0.01 for both). History of diabetes mellitus and hypertension were also significant predictors of poor clinical outcome at 90 days, but this was only observed for cortical stroke (p<0.001 and p=0.003). Conclusion: In this study, intravenous thrombolysis yielded significant clinical outcomes for patients with cortical stroke but not patients with lacunar stroke.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".