Intravenous Thrombolytic Treatment in the Oldest Old
Background and Purpose. Intravenous thrombolysis using tissue plasminogen activator is safe and probably effective in patients >80 years old. Nevertheless, its safety has not been specifically addressed for the oldest old patients (≥85 years old, OO). We assessed the safety and effectiveness of t...
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| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2012-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2012/923676 |
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| author | Juan García-Caldentey María Alonso de Leciñana Patricia Simal Blanca Fuentes Gemma Reig Fernando Díaz-Otero Marta Guillán Ana García Patricia Martínez Andrés García-Pastor José Antonio Egido Exuperio Díez-Tejedor Antonio Gil-Núñez José Vivancos Jaime Masjuan |
| author_facet | Juan García-Caldentey María Alonso de Leciñana Patricia Simal Blanca Fuentes Gemma Reig Fernando Díaz-Otero Marta Guillán Ana García Patricia Martínez Andrés García-Pastor José Antonio Egido Exuperio Díez-Tejedor Antonio Gil-Núñez José Vivancos Jaime Masjuan |
| author_sort | Juan García-Caldentey |
| collection | DOAJ |
| description | Background and Purpose. Intravenous thrombolysis using tissue plasminogen activator is safe and probably effective in patients >80 years old. Nevertheless, its safety has not been specifically addressed for the oldest old patients (≥85 years old, OO). We assessed the safety and effectiveness of thrombolysis in this group of age. Methods. A prospective registry of patients treated with intravenous thrombolysis. Patients were divided in two groups (<85 years and the OO). Demographic data, stroke aetiology and baseline National Institute Health Stroke Scale (NIHSS) score were recorded. The primary outcome measures were the percentage of symptomatic intracranial haemorrhage (SICH) and functional outcome at 3 months (modified Rankin Scale, mRS). Results.
A total of 1,505 patients were registered. 106 patients were OO [median 88, range 85–101]. Female sex, hypertension, elevated blood pressure at admission, cardioembolic strokes and higher basal NIHSS score were more frequent in the OO. SICH transformation rates were similar (3.1% versus 3.7%, P=1.00). The probability of independence at 3 months (mRS 0–2) was lower in the OO (40.2% versus 58.7%, P=0.001) but not after adjustment for confounding factors (adjusted OR, 0.82; 95% CI, 0.50 to 1.37; P=0.455). Three-month mortality was higher in the OO (28.0% versus 11.5%, P<0.001). Conclusion.
Intravenous thrombolysis for stroke in OO patients did not increase the risk of SICH although mortality was higher in this group. |
| format | Article |
| id | doaj-art-e220d2119c344532a7dcfe15a6c14e71 |
| institution | OA Journals |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-e220d2119c344532a7dcfe15a6c14e712025-08-20T02:21:16ZengWileyStroke Research and Treatment2090-81052042-00562012-01-01201210.1155/2012/923676923676Intravenous Thrombolytic Treatment in the Oldest OldJuan García-Caldentey0María Alonso de Leciñana1Patricia Simal2Blanca Fuentes3Gemma Reig4Fernando Díaz-Otero5Marta Guillán6Ana García7Patricia Martínez8Andrés García-Pastor9José Antonio Egido10Exuperio Díez-Tejedor11Antonio Gil-Núñez12José Vivancos13Jaime Masjuan14Stroke Center, Department of Neurology, University Hospital Ramon y Cajal, IRYCIS, Health Research Institute, University of Alcalá de Henares, 28034 Madrid, SpainStroke Center, Department of Neurology, University Hospital Ramon y Cajal, IRYCIS, Health Research Institute, University of Alcalá de Henares, 28034 Madrid, SpainStroke Center, Department of Neurology, University Hospital Clínico San Carlos, The Complutense University, 28040 Madrid, SpainStroke Center, Department of Neurology, Neurosciences Research, IdiPAZ, Health Research Institute, University Hospital La Paz, Autonoma University of Madrid, 28046 Madrid, SpainStroke Center, Department of Neurology, Princesa Health Research Institute, University Hospital La Princesa, Autonoma University, 28006 Madrid, SpainStroke Center, Department of Neurology, University Hospital Gregorio Marañon, Complutense University, 28009 Madrid, SpainStroke Center, Department of Neurology, University Hospital Ramon y Cajal, IRYCIS, Health Research Institute, University of Alcalá de Henares, 28034 Madrid, SpainStroke Center, Department of Neurology, University Hospital Clínico San Carlos, The Complutense University, 28040 Madrid, SpainStroke Center, Department of Neurology, Neurosciences Research, IdiPAZ, Health Research Institute, University Hospital La Paz, Autonoma University of Madrid, 28046 Madrid, SpainStroke Center, Department of Neurology, University Hospital Gregorio Marañon, Complutense University, 28009 Madrid, SpainStroke Center, Department of Neurology, University Hospital Clínico San Carlos, The Complutense University, 28040 Madrid, SpainStroke Center, Department of Neurology, Neurosciences Research, IdiPAZ, Health Research Institute, University Hospital La Paz, Autonoma University of Madrid, 28046 Madrid, SpainStroke Center, Department of Neurology, University Hospital Gregorio Marañon, Complutense University, 28009 Madrid, SpainStroke Center, Department of Neurology, Princesa Health Research Institute, University Hospital La Princesa, Autonoma University, 28006 Madrid, SpainStroke Center, Department of Neurology, University Hospital Ramon y Cajal, IRYCIS, Health Research Institute, University of Alcalá de Henares, 28034 Madrid, SpainBackground and Purpose. Intravenous thrombolysis using tissue plasminogen activator is safe and probably effective in patients >80 years old. Nevertheless, its safety has not been specifically addressed for the oldest old patients (≥85 years old, OO). We assessed the safety and effectiveness of thrombolysis in this group of age. Methods. A prospective registry of patients treated with intravenous thrombolysis. Patients were divided in two groups (<85 years and the OO). Demographic data, stroke aetiology and baseline National Institute Health Stroke Scale (NIHSS) score were recorded. The primary outcome measures were the percentage of symptomatic intracranial haemorrhage (SICH) and functional outcome at 3 months (modified Rankin Scale, mRS). Results. A total of 1,505 patients were registered. 106 patients were OO [median 88, range 85–101]. Female sex, hypertension, elevated blood pressure at admission, cardioembolic strokes and higher basal NIHSS score were more frequent in the OO. SICH transformation rates were similar (3.1% versus 3.7%, P=1.00). The probability of independence at 3 months (mRS 0–2) was lower in the OO (40.2% versus 58.7%, P=0.001) but not after adjustment for confounding factors (adjusted OR, 0.82; 95% CI, 0.50 to 1.37; P=0.455). Three-month mortality was higher in the OO (28.0% versus 11.5%, P<0.001). Conclusion. Intravenous thrombolysis for stroke in OO patients did not increase the risk of SICH although mortality was higher in this group.http://dx.doi.org/10.1155/2012/923676 |
| spellingShingle | Juan García-Caldentey María Alonso de Leciñana Patricia Simal Blanca Fuentes Gemma Reig Fernando Díaz-Otero Marta Guillán Ana García Patricia Martínez Andrés García-Pastor José Antonio Egido Exuperio Díez-Tejedor Antonio Gil-Núñez José Vivancos Jaime Masjuan Intravenous Thrombolytic Treatment in the Oldest Old Stroke Research and Treatment |
| title | Intravenous Thrombolytic Treatment in the Oldest Old |
| title_full | Intravenous Thrombolytic Treatment in the Oldest Old |
| title_fullStr | Intravenous Thrombolytic Treatment in the Oldest Old |
| title_full_unstemmed | Intravenous Thrombolytic Treatment in the Oldest Old |
| title_short | Intravenous Thrombolytic Treatment in the Oldest Old |
| title_sort | intravenous thrombolytic treatment in the oldest old |
| url | http://dx.doi.org/10.1155/2012/923676 |
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