Identifying predictors of good response in thrombolytic-treated stroke is important to clinical care, resource allocation, and research design. We developed a simple, novel measure of “Good Responders” to assess if two short-term variables could predict 90-day outcomes after thrombolysis in stroke.

Intravenous thrombolysis-treated stroke cases from June 2004 to June 2018 were analyzed from a stroke registry. Intraarterial treatment cases were excluded. Good responders (GR++) were defined as those with length of stay ≤3 days and discharge to home. Poor responders (GR--) had length of stay >3 days and discharge other than home. Mixed responders (GR+/-) composed the remainder. Baseline characteristics and predictors of 90-day outcome were assessed.

Of 261 patients, there were 101(38.7%) GR++, 67(25.7%) GR--, and 93(35.6%) GR+-. For GR++ versus GR-- versus GR+-, there were differences in mean age (62.7, 71.2, 69.2;p=0.0016), and baseline modified Rankin score (mRS) 0-2 (%:94.9, 74.6, 84.8;p=0.008). Younger age, male sex, lower values for systolic BP, glucose, and baseline mRS were associated with good responders. Older age, atrial fibrillation, symptomatic intracerebral hemorrhage, and baseline mRS>2 were associated with poor responders. At 90 days, mortality was reduced in GR++ versus GR--versus GR+- (%alive: 92.6, 72, 86;p=0.04), and mRS(0-2) (%: 36.8, 0, 11.8;p<0.001).