Int J Biometeorol. 2026 May 18;70(6):164. doi: 10.1007/s00484-026-03232-2.
ABSTRACT
We determined whether environmental temperature affects the time delay and clinical outcomes in patients with acute ischemic stroke receiving intravenous recombinant tissue plasminogen activator (rt-PA) thrombolysis. We analyzed patient characteristics, severity of neurological impairment, and functional outcomes at 90 days in a cohort of 1,959 patients (median age, 65 [56-75] years) from the Stroke Emergency Map Registry Center of Taiyuan, Shanxi Province (China), of whom 899 (45.89%) received rt-PA during the cold season. Patients treated during the warm season exhibited a shorter time from onset to door and shorter time from onset to intravenous thrombolysis start. Furthermore, they were more likely to achieve a non-disabled outcome (modified Rankin score [mRS] 0-1) and favorable clinical outcome (mRS 0-2) at 90 days. Although the season did not independently predict the 90-day mortality risk, a rise in temperature significantly reduced the mortality rate only in the cold season. A nonlinear relationship was observed between the mean temperature on the day of stroke onset and neurological function recovery in surviving patients 7 days post-intravenous thrombolysis. When the temperature was approximately 10 °C, neurological recovery was relatively good at 7 days. The cumulative lag effect at 1 day significantly influenced patients' neurological function compared to that at 7 days. We conclude that lower ambient temperatures may be associated with delayed intravenous thrombolysis and poorer functional outcomes in patients with ischemic stroke. Further studies are needed to minimize treatment delays in patients with stroke caused by adverse weather conditions to improve outcomes.
PMID:42149238 | DOI:10.1007/s00484-026-03232-2