Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80

Abstract Background The implementation of acute stroke care programs with dedicated multidisciplinary stroke teams has revolutionized access to care and improved survival among older adults. However, the integration of specialized palliative support within acute stroke services remains uncommon in m...

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Main Authors: Greta Sahakyan, Mira Orduyan, Ani Adamyan, Karen Koshtoyan, Gurgen Hovhannisyan, Aleksandra Karapetyan, Hovhannes Manvelyan
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Palliative Care
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Online Access:https://doi.org/10.1186/s12904-025-01773-8
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author Greta Sahakyan
Mira Orduyan
Ani Adamyan
Karen Koshtoyan
Gurgen Hovhannisyan
Aleksandra Karapetyan
Hovhannes Manvelyan
author_facet Greta Sahakyan
Mira Orduyan
Ani Adamyan
Karen Koshtoyan
Gurgen Hovhannisyan
Aleksandra Karapetyan
Hovhannes Manvelyan
author_sort Greta Sahakyan
collection DOAJ
description Abstract Background The implementation of acute stroke care programs with dedicated multidisciplinary stroke teams has revolutionized access to care and improved survival among older adults. However, the integration of specialized palliative support within acute stroke services remains uncommon in many developing countries. This study highlights the emerging challenges faced by patients with ischemic stroke aged ≥ 80 years treated with reperfusion therapies, identifies early palliative care needs, and underscores the importance of comprehensive support in the acute setting. Methods We selected consecutive patients with ischemic stroke aged ≥ 80 years who received reperfusion therapies (intravenous thrombolysis or mechanical thrombectomy) at the time of stroke unit admission. Clinical and demographic data were prospectively collected and analyzed. Results A total of 52 patients aged ≥ 80 years received reperfusion therapies. The in-hospital mortality rate was 5/52 (9.6%). Key challenges identified during hospitalization included dysphagia in 32 patients (61.5%), dyspnea in 7 patients (13.5%), delirium in 14 patients (26.9%), and mobility impairment and/or speech disturbance in 22 patients (42.3%). Conclusion Despite the increasing use of reperfusion therapies in patients aged ≥ 80 years, symptoms requiring comprehensive support and early palliative interventions persist in the acute stroke setting. Our findings emphasize the need for early palliative assessments to address stroke-related symptoms such as dysphagia, delirium, and mobility or speech disturbances, ultimately enhancing patient comfort. Future research is necessary to better understand stroke-specific symptom burden in the aging population and to develop strategies for integrating palliative care into acute stroke management.
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spelling doaj-art-e9d9a463a80344aab4c7233f38d8b1792025-08-20T02:15:11ZengBMCBMC Palliative Care1472-684X2025-05-012411510.1186/s12904-025-01773-8Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80Greta Sahakyan0Mira Orduyan1Ani Adamyan2Karen Koshtoyan3Gurgen Hovhannisyan4Aleksandra Karapetyan5Hovhannes Manvelyan6Department of Neurology, Yerevan State Medical UniversityDepartment of Neurology, Astghik Medical CenterDepartment of Neurology, Astghik Medical CenterDepartment of Neurology, Yerevan State Medical UniversityDepartment of Neurology, Yerevan State Medical UniversityDepartment of Family Medicine, Yerevan State Medical UniversityDepartment of Neurology, Yerevan State Medical UniversityAbstract Background The implementation of acute stroke care programs with dedicated multidisciplinary stroke teams has revolutionized access to care and improved survival among older adults. However, the integration of specialized palliative support within acute stroke services remains uncommon in many developing countries. This study highlights the emerging challenges faced by patients with ischemic stroke aged ≥ 80 years treated with reperfusion therapies, identifies early palliative care needs, and underscores the importance of comprehensive support in the acute setting. Methods We selected consecutive patients with ischemic stroke aged ≥ 80 years who received reperfusion therapies (intravenous thrombolysis or mechanical thrombectomy) at the time of stroke unit admission. Clinical and demographic data were prospectively collected and analyzed. Results A total of 52 patients aged ≥ 80 years received reperfusion therapies. The in-hospital mortality rate was 5/52 (9.6%). Key challenges identified during hospitalization included dysphagia in 32 patients (61.5%), dyspnea in 7 patients (13.5%), delirium in 14 patients (26.9%), and mobility impairment and/or speech disturbance in 22 patients (42.3%). Conclusion Despite the increasing use of reperfusion therapies in patients aged ≥ 80 years, symptoms requiring comprehensive support and early palliative interventions persist in the acute stroke setting. Our findings emphasize the need for early palliative assessments to address stroke-related symptoms such as dysphagia, delirium, and mobility or speech disturbances, ultimately enhancing patient comfort. Future research is necessary to better understand stroke-specific symptom burden in the aging population and to develop strategies for integrating palliative care into acute stroke management.https://doi.org/10.1186/s12904-025-01773-8GeriatricsPalliative needsIschemic strokeReperfusion therapies
spellingShingle Greta Sahakyan
Mira Orduyan
Ani Adamyan
Karen Koshtoyan
Gurgen Hovhannisyan
Aleksandra Karapetyan
Hovhannes Manvelyan
Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
BMC Palliative Care
Geriatrics
Palliative needs
Ischemic stroke
Reperfusion therapies
title Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
title_full Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
title_fullStr Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
title_full_unstemmed Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
title_short Unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
title_sort unaddressed palliative care needs of ischemic stroke patients treated with reperfusion therapies after age 80
topic Geriatrics
Palliative needs
Ischemic stroke
Reperfusion therapies
url https://doi.org/10.1186/s12904-025-01773-8
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