Efficacy of implementation of the FeSS protocol in thrombolysed stroke patients from Institute of Emergency Medicine

Abstract

Background: Implementation of intravenous thrombolysis for acute ischemic stroke has significant impact on stroke outcome by reducing disability and post-stroke mortality rates. However, high risk for developing early complications persists. That’s why, FeSS Protocol (additional screenings for blood glucose, temperature control and swallowing monitoring) has been implemented. The purpose of the study was to analyze the efficacy of the FeSS Protocol in reduction of complication rate after intravenous thrombolysis. We compared the data before and after its implementation. Material and methods: Patients from Institute of Emergency Medicine who underwent thrombolytic treatment were included in this study. The rates of general and hemorrhagic complications were analyzed by comparing the period before (2015 – 2017) and after (2018 – 2020) implementation of the FeSS Protocol. Results: According to the obtained data, in 2015 – 2017 period, 63 patients underwent the thrombolysis procedure, and in 2018 – 2020 – 124 patients. The rate of hemorrhagic complications in the first period was 11 (17.5%), 4 of which (6.3%) were fatal. In the second period there were 14 (11.2%) hemorrhagic complications, without any fatal cases. The percentage of general complications was higher in the first group – 32%, compared to 19.4% in the second group. Conclusions: Hyperglycemia, fever and swallowing disturbances in the early post-stroke period are predisposing factors for the development of hemorrhagic and general complications, which negatively affect recovery after stroke. Tight monitoring and management of these parameters can improve the clinical and functional outcome of stroke patients.