Literature DB >> 22367841

Safety of thrombolysis in patients over the age of 80.

Joshua Zebadiah Willey1, Nils Petersen, Mandip S Dhamoon, Joshua Stillman, Bernadette Boden-Albala, Mitchell S V Elkind, Randolph S Marshall.   

Abstract

BACKGROUND: The safety of intravenous thrombolysis (IVT) in patients with acute ischemic stroke over the age of 80 is unclear. We hypothesized that patients over the age of 80 can be safely treated with IVT.
METHODS: Admission and discharge data were collected on all patients at a single tertiary care center presenting within 12 hours of onset. Collected data included treatment with IVT, demographics, pretreatment National Institutes of Health Stroke Scale score, length of stay, mortality, and discharge disposition. Analyses were restricted to patients over the age of 80, and the primary outcome was in-hospital mortality. Logistic regression was used to examine whether IVT was associated with mortality.
RESULTS: Between January 1, 2005 and May 30, 2010, 112 patients over the age of 80 presented within 3 hours of ischemic stroke onset, and 31 received IVT. There were 15 deaths. In multivariable models adjusted for age, sex, race-ethnicity, and National Institutes of Health Stroke Scale, treatment with IVT, compared with no treatment, was not associated with in-hospital death (adjusted odds ratio, 1.2; 95% confidence interval, 0.3-4.3).
CONCLUSIONS: Treating ischemic stroke patients over 80 years with IVT was not associated with an increase in mortality in an urban tertiary care center.

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Year:  2012        PMID: 22367841      PMCID: PMC3292776          DOI: 10.1097/NRL.0b013e318248ea3c

Source DB:  PubMed          Journal:  Neurologist        ISSN: 1074-7931            Impact factor:   1.398


  20 in total

1.  Intravenous tissue plasminogen activator for acute ischemic stroke in patients aged 80 years and older : the tPA stroke survey experience.

Authors:  D Tanne; M J Gorman; V E Bates; S E Kasner; P Scott; P Verro; J R Binder; J M Dayno; L R Schultz; S R Levine
Journal:  Stroke       Date:  2000-02       Impact factor: 7.914

2.  Thrombolysis in elderly people. Observational data insufficient to change treatment.

Authors:  Richard I Lindley; Joanna M Wardlaw; Peter A G Sandercock
Journal:  BMJ       Date:  2011-01-19

3.  Outcome and severe hemorrhagic complications of intravenous thrombolysis with tissue plasminogen activator in very old (> or =80 years) stroke patients.

Authors:  Jörg Berrouschot; Joachim Röther; Jörg Glahn; Thomas Kucinski; Jens Fiehler; Götz Thomalla
Journal:  Stroke       Date:  2005-10-06       Impact factor: 7.914

4.  Intravenous TPA for very old stroke patients.

Authors:  Chin-I Chen; Yasuyuki Iguchi; James C Grotta; Zsolt Garami; Ken Uchino; Hashem Shaltoni; Andrei V Alexandrov
Journal:  Eur Neurol       Date:  2005-10-18       Impact factor: 1.710

5.  Predictors of in-hospital mortality in patients with acute ischemic stroke treated with thrombolytic therapy.

Authors:  Peter U Heuschmann; Peter L Kolominsky-Rabas; Joachim Roether; Bjoern Misselwitz; Klaus Lowitzsch; Jan Heidrich; Peter Hermanek; Carsten Leffmann; Matthias Sitzer; Marcel Biegler; Hans-Joachim Buecker-Nott; Klaus Berger
Journal:  JAMA       Date:  2004-10-20       Impact factor: 56.272

6.  Thrombolysis in stroke patients aged 80 years and older: Swiss survey of IV thrombolysis.

Authors:  S T Engelter; M Reichhart; L Sekoranja; D Georgiadis; A Baumann; B Weder; F Müller; R Lüthy; M Arnold; P Michel; H P Mattle; B Tettenborn; H J Hungerbühler; R W Baumgartner; R Sztajzel; J Bogousslavsky; P A Lyrer
Journal:  Neurology       Date:  2005-10-12       Impact factor: 9.910

7.  Intravenous rt-PA for acute stroke: comparing its effectiveness in younger and older patients.

Authors:  M S Mouradian; A Senthilselvan; G Jickling; J A McCombe; D J Emery; N Dean; A Shuaib
Journal:  J Neurol Neurosurg Psychiatry       Date:  2005-09       Impact factor: 10.154

8.  Thrombolysis for acute stroke with special emphasis on the very old: experience from a single Dutch centre.

Authors:  R J van Oostenbrugge; R M M Hupperts; J Lodder
Journal:  J Neurol Neurosurg Psychiatry       Date:  2006-03       Impact factor: 10.154

9.  Strokes in the elderly - higher acute and 3-month mortality - an explanation.

Authors:  J C Sharma; S Fletcher; M Vassallo
Journal:  Cerebrovasc Dis       Date:  1999 Jan-Feb       Impact factor: 2.762

10.  Is intravenous recombinant tissue plasminogen activator (rt-PA) safe for use in patients over 80 years old with acute ischaemic stroke? - The Calgary experience.

Authors:  Jessica E Simon; David L Sandler; J H Warwick Pexman; Michael D Hill; Alastair M Buchan
Journal:  Age Ageing       Date:  2004-03       Impact factor: 10.668

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  3 in total

1.  Analysis of tissue plasminogen activator eligibility by sex in the Greater Cincinnati/Northern Kentucky Stroke Study.

Authors:  Tracy E Madsen; Jane C Khoury; Kathleen A Alwell; Charles J Moomaw; Brett M Kissela; Felipe De Los Rios La Rosa; Daniel Woo; Opeolu Adeoye; Matthew L Flaherty; Pooja Khatri; Simona Ferioli; Dawn Kleindorfer
Journal:  Stroke       Date:  2015-01-27       Impact factor: 7.914

Review 2.  Effectiveness of alteplase in the very elderly after acute ischemic stroke.

Authors:  Josef Yayan
Journal:  Clin Interv Aging       Date:  2013-07-24       Impact factor: 4.458

3.  Racial Disparities in Intravenous Recombinant Tissue Plasminogen Activator Use Persist at Primary Stroke Centers.

Authors:  Hugo J Aparicio; Brendan G Carr; Scott E Kasner; Michael J Kallan; Karen C Albright; Dawn O Kleindorfer; Michael T Mullen
Journal:  J Am Heart Assoc       Date:  2015-10-14       Impact factor: 5.501

  3 in total

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