Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018
Intravenous thrombolysis with alteplase within 4.5 hours from symptom onset is a well-established treatment of acute ischaemic stroke (AIS). The aim was to compare alteplase for AIS between patients aged >80 and ≤80 years in our registry data, from 2013 to 2018. Mechanical thrombectomy cases were...
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| Format: | Article |
| Language: | English |
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Wiley
2021-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2021/3738017 |
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| author | Xuya Huang Phillip Nash Vafa Alakbarzade Brian Clarke Anthony C. Pereira |
| author_facet | Xuya Huang Phillip Nash Vafa Alakbarzade Brian Clarke Anthony C. Pereira |
| author_sort | Xuya Huang |
| collection | DOAJ |
| description | Intravenous thrombolysis with alteplase within 4.5 hours from symptom onset is a well-established treatment of acute ischaemic stroke (AIS). The aim was to compare alteplase for AIS between patients aged >80 and ≤80 years in our registry data, from 2013 to 2018. Mechanical thrombectomy cases were excluded. We assessed clinical outcomes over the six-year period and between patients aged over 80 and ≤80 years, using measures including the discharge modified Rankin Scale (mRS), 24-hour National Institutes of Health Stroke Scale (NIHSS) improvement, and symptomatic intracerebral haemorrhage (sICH) rate. Of a total of 805 AIS patients who received intravenous alteplase, 278 (34.5%) were over 80 years old, and 527 (65%) were younger. 616 (76.5%) received thrombolysis≤3 hours after symptom onset and 189 (23.5%) within 3-4.5 hours. Median baseline mRS and NIHSS of the elderly cohort were 1 (IQR 0-5) and 13 (IQR 2-37), respectively, compared to the younger cohort 0 (IQR 0-5) and 9 (IQR 0-29). The sICH rate was 7.2% in the elderly and 4.6% in those ≤80 years, p=0.05. NIHSS improved within 24 hours in 34% of the elderly cohort compared to 35% in the younger cohort. At hospital discharge, the mortality rate was 9% in the elderly cohort compared to the 6% in the younger cohort, p=0.154. 25% of patients aged >80 years had mRS≤2 compared to 47% in the younger patients (p<0.0001). In conclusion, thrombolysis in elderly patients results in clinical improvement comparable to younger patients. |
| format | Article |
| id | doaj-art-ddcc84811de64e1e9d19f274fa242be7 |
| institution | Kabale University |
| issn | 2042-0056 |
| language | English |
| publishDate | 2021-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-ddcc84811de64e1e9d19f274fa242be72025-08-20T03:26:21ZengWileyStroke Research and Treatment2042-00562021-01-01202110.1155/2021/3738017Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018Xuya Huang0Phillip Nash1Vafa Alakbarzade2Brian Clarke3Anthony C. Pereira4Neurology DepartmentNeurology DepartmentNeurology DepartmentNeurology DepartmentNeurology DepartmentIntravenous thrombolysis with alteplase within 4.5 hours from symptom onset is a well-established treatment of acute ischaemic stroke (AIS). The aim was to compare alteplase for AIS between patients aged >80 and ≤80 years in our registry data, from 2013 to 2018. Mechanical thrombectomy cases were excluded. We assessed clinical outcomes over the six-year period and between patients aged over 80 and ≤80 years, using measures including the discharge modified Rankin Scale (mRS), 24-hour National Institutes of Health Stroke Scale (NIHSS) improvement, and symptomatic intracerebral haemorrhage (sICH) rate. Of a total of 805 AIS patients who received intravenous alteplase, 278 (34.5%) were over 80 years old, and 527 (65%) were younger. 616 (76.5%) received thrombolysis≤3 hours after symptom onset and 189 (23.5%) within 3-4.5 hours. Median baseline mRS and NIHSS of the elderly cohort were 1 (IQR 0-5) and 13 (IQR 2-37), respectively, compared to the younger cohort 0 (IQR 0-5) and 9 (IQR 0-29). The sICH rate was 7.2% in the elderly and 4.6% in those ≤80 years, p=0.05. NIHSS improved within 24 hours in 34% of the elderly cohort compared to 35% in the younger cohort. At hospital discharge, the mortality rate was 9% in the elderly cohort compared to the 6% in the younger cohort, p=0.154. 25% of patients aged >80 years had mRS≤2 compared to 47% in the younger patients (p<0.0001). In conclusion, thrombolysis in elderly patients results in clinical improvement comparable to younger patients.http://dx.doi.org/10.1155/2021/3738017 |
| spellingShingle | Xuya Huang Phillip Nash Vafa Alakbarzade Brian Clarke Anthony C. Pereira Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018 Stroke Research and Treatment |
| title | Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018 |
| title_full | Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018 |
| title_fullStr | Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018 |
| title_full_unstemmed | Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018 |
| title_short | Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018 |
| title_sort | clinical outcomes after intravenous alteplase in elderly patients with acute ischaemic stroke a retrospective analysis of patients treated at a tertiary neurology centre in england from 2013 to 2018 |
| url | http://dx.doi.org/10.1155/2021/3738017 |
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