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 journalArticlepeer-review

18 Citations (Scopus)


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
Issue number2
Publication statusPublished - 2011 Sep 1

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

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