Outcome of acute ischemic stroke in very elderly patients: Is intravenous thrombolysis beneficial?

Pi-Shan Sung, Chih-Hung Chen, Han Chieh Hsieh, Chen Wen Fang, Cheng Yang Hsieh, Yuan-Ting Sun, Wen Juh Hwang

Research output: Contribution to journalArticle

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Abstract

Background/Aims: Intravenous tissue plasminogen activator (tPA) treatment is recommended in acute stroke within 3 h of onset; however, the benefit of its use in the elderly remains uncertain. We assessed the safety and efficacy of tPA treatment in elderly patients. Methods: We recruited 97 elderly Chinese patients aged ≥80 years with cerebral ischemia presenting within 3 h of onset. Favorable outcomes were defined as discharge to home and modified Rankin Scale (mRS) ≤2 at discharge. Results: For moderate to severe patients (NIHSS ≥6), the baseline characteristics between the tPA (n = 30) and non-tPA (n = 41) group were not different. The proportion of patients discharged home was 56.7 and 61%, respectively (p = 0.72). For patients with baseline mRS ≤2, the frequency of discharged mRS ≤2 was not different (27.3% of the tPA group and 26.9% of the non-tPA group; p = 1.00). Symptomatic intracranial hemorrhage was 6.7 and 2.4%, respectively (p = 0.31). For minor stroke patients (NIHSS ≤5), tPA was not considered and the outcome of those discharged home and mRS ≤2 was 73 and 88%, respectively. Conclusion: Elderly patients can be treated safely with intravenous tPA, whereas our data did not support routine thrombolysis. Further randomized trials in the elderly are encouraged.

Original languageEnglish
Pages (from-to)110-116
Number of pages7
JournalEuropean Neurology
Volume66
Issue number2
DOIs
Publication statusPublished - 2011 Sep 1

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Tissue Plasminogen Activator
Stroke
Plasminogen Activators
Intracranial Hemorrhages
Brain Ischemia
Safety
Therapeutics

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Sung, Pi-Shan ; Chen, Chih-Hung ; Hsieh, Han Chieh ; Fang, Chen Wen ; Hsieh, Cheng Yang ; Sun, Yuan-Ting ; Hwang, Wen Juh. / Outcome of acute ischemic stroke in very elderly patients : Is intravenous thrombolysis beneficial?. In: European Neurology. 2011 ; Vol. 66, No. 2. pp. 110-116.
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abstract = "Background/Aims: Intravenous tissue plasminogen activator (tPA) treatment is recommended in acute stroke within 3 h of onset; however, the benefit of its use in the elderly remains uncertain. We assessed the safety and efficacy of tPA treatment in elderly patients. Methods: We recruited 97 elderly Chinese patients aged ≥80 years with cerebral ischemia presenting within 3 h of onset. Favorable outcomes were defined as discharge to home and modified Rankin Scale (mRS) ≤2 at discharge. Results: For moderate to severe patients (NIHSS ≥6), the baseline characteristics between the tPA (n = 30) and non-tPA (n = 41) group were not different. The proportion of patients discharged home was 56.7 and 61{\%}, respectively (p = 0.72). For patients with baseline mRS ≤2, the frequency of discharged mRS ≤2 was not different (27.3{\%} of the tPA group and 26.9{\%} of the non-tPA group; p = 1.00). Symptomatic intracranial hemorrhage was 6.7 and 2.4{\%}, respectively (p = 0.31). For minor stroke patients (NIHSS ≤5), tPA was not considered and the outcome of those discharged home and mRS ≤2 was 73 and 88{\%}, respectively. Conclusion: Elderly patients can be treated safely with intravenous tPA, whereas our data did not support routine thrombolysis. Further randomized trials in the elderly are encouraged.",
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Outcome of acute ischemic stroke in very elderly patients : Is intravenous thrombolysis beneficial? / Sung, Pi-Shan; Chen, Chih-Hung; Hsieh, Han Chieh; Fang, Chen Wen; Hsieh, Cheng Yang; Sun, Yuan-Ting; Hwang, Wen Juh.

In: European Neurology, Vol. 66, No. 2, 01.09.2011, p. 110-116.

Research output: Contribution to journalArticle

TY - JOUR

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T2 - Is intravenous thrombolysis beneficial?

AU - Sung, Pi-Shan

AU - Chen, Chih-Hung

AU - Hsieh, Han Chieh

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AU - Hsieh, Cheng Yang

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