Objective: To evaluate the treatment outcomes of an intravenous recombinant tissue plasminogen activator (rt-PA) therapy in acute ischemic stroke from a national database. 

Materials and Methods: This study was a retrospective analytical study. The database used in this study was a Universal Health Coverage (UHC) insurance of Thailand. The inclusion criteria were consecutive adult patients diagnosed as acute ischemic stroke and admitted to the hospital. The study period was between October 1^st, 2004 to January 31^st, 2013. We compared stroke outcomes, and stroke complications between those who received and did not receive the rt-PA treatment.

Results: During the study period, there were 244,032 patients met the study criteria. Of those, 2,102 patients (0.9%) received the rt-PA treatment. The rt-PA group had significant better discharge statuses than the no rt-PA group except death (6.9% vs 6.0%; p value 0.151). There were six significant differences in terms of stroke complications between both groups. The rt-PA group had higher rates of complication in five items than the no rt-PA group. The no rt-PA group had only significant higher rate of sepsis than the rt-PA group (3.4% vs 2.8%; p value 0.015).

Conclusions: The rt-PA treatment in acute ischemic stroke patients with the UHC had benefit on discharge status. Some complications of stroke in the rt-PA treatment were significantly higher than no rt-PA treatment.

Keywords: functional status, outcomes, complications