Introduction: Two-thirds of stroke cases in Indonesia are acute ischemic strokes. Intravenous thrombolysis therapy is one of treatment options for acute ischemic stroke. Aims: To determine the factors influencing outcomes of intravenous thrombolysis in patients with acute ischemic stroke at Dr.M.Djamil Hospital Padang. Methods: A descriptive-analytical study using total sampling of medical records of patients with acute ischemic stroke who underwent intravenous thrombolysis at Dr.M.Djamil Hospital from January 2023 to March 2024. Data analysis using SPSS, bivariate analysis using chi-square followed by multivariate analysis using multiple logistic regression to identify the most influential factors outcomes of intravenous thrombolysis based on mRS scores <2 (good outcome) and mRS scores >2 (poor outcome). Results: Out of 45 patients included in the study, 62.2% were male and 37.78% were female. The mean onset time was 3.5±1.50 hours with a mean door-to-needle time of 42.33±7.125 minutes, and a mean rt-PA dose of 46.31±9.774 mg. Bivariate analysis results six influential factors are diabetes mellitus (p=0.188), GCS (p=<001), NIHSS (p=<0.001), length of hospital stay (p=0.106), stroke type (p=0.148), and initial CT scan (p=0.002). Multivariate analysis identified the most influential factors outcomes of intravenous thrombolysis as NIHSS score (OR=27.982), GCS (OR=8.268), diabetes mellitus (OR=6.792), and CT scan results (OR=6.635). Discussion: NIHSS is the most influential factor outcomes of intravenous thrombolysis. Intravenous thrombolysis therapy is one of treatment options for acute ischemic stroke, but shows worse outcomes in patients with large vessel occlusion (LVO), low GCS, hyperglycemia, and high NIHSS scores. Keywords: Intravenous Thrombolysis, Ischemic Stroke, NIHSS
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