Mu-Chien Sun1, Tien-Bao Lai2, Jiann-Shing Jeng3, Sheng-Feng Sung4, Pi-Shan Sung5, Sung-Chun Tang3, Wei-Liang Chen6, Chih-Hung Chen5. 1. Stroke Center, Changhua Christian Hospital, Changhua, Taiwan Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan. 2. Stroke Center, Changhua Christian Hospital, Changhua, Taiwan Department of Emergency Medicine, Changhua Christian Hospital, Changhua, Taiwan. 3. Stroke Center and Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. 4. Division of Neurology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan. 5. Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 6. Stroke Center, Changhua Christian Hospital, Changhua, Taiwan Department of Radiology, Changhua Christian Hospital, Changhua, Taiwan.
Abstract
BACKGROUND: symptomatic intracerebral haemorrhage (ICH) is a major concern of intravenous thrombolysis (IVT) for ischaemic stroke. Asians are considered more vulnerable to ICH than non-Asians. Reports on safety of IVT for Asian octogenarians and nonagenarians are limited. AIMS: the aims of our study were to compare the safety of IVT between octogenarians and nonagenarians and between Asian and Western patients. METHODS: patients receiving IVT for ischaemic stroke were prospectively registered from four hospitals in Taiwan. Octogenarians and nonagenarians were recruited for analysis. The primary safety outcome measure was symptomatic ICH. The secondary outcome measure was 3-month mortality. We searched the literature on IVT for ischaemic stroke for comparison. RESULTS: from January 2007 to December 2012, a total of 186 (18.3%) ischaemic stroke patients aged 80 and older, including 166 octogenarians and 20 nonagenarians, were recruited from 1,018 patients receiving IVT. Nine (4.8%) of recruited patients had symptomatic ICH, all in the octogenarian group (5.4%). Three-month mortality was 14.1% in recruited patients and without difference between the two age groups (P = 0.558). The results were comparable with reports on Western octogenarians and nonagenarians in the literature. CONCLUSION: octogenarians and nonagenarians receiving IVT have a similar safety outcome. Asian octogenarians and nonagenarians receiving IVT for ischaemic stroke are not at higher risk of symptomatic ICH and mortality than Western patients.
BACKGROUND: symptomatic intracerebral haemorrhage (ICH) is a major concern of intravenous thrombolysis (IVT) for ischaemic stroke. Asians are considered more vulnerable to ICH than non-Asians. Reports on safety of IVT for Asian octogenarians and nonagenarians are limited. AIMS: the aims of our study were to compare the safety of IVT between octogenarians and nonagenarians and between Asian and Western patients. METHODS:patients receiving IVT for ischaemic stroke were prospectively registered from four hospitals in Taiwan. Octogenarians and nonagenarians were recruited for analysis. The primary safety outcome measure was symptomatic ICH. The secondary outcome measure was 3-month mortality. We searched the literature on IVT for ischaemic stroke for comparison. RESULTS: from January 2007 to December 2012, a total of 186 (18.3%) ischaemic strokepatients aged 80 and older, including 166 octogenarians and 20 nonagenarians, were recruited from 1,018 patients receiving IVT. Nine (4.8%) of recruited patients had symptomatic ICH, all in the octogenarian group (5.4%). Three-month mortality was 14.1% in recruited patients and without difference between the two age groups (P = 0.558). The results were comparable with reports on Western octogenarians and nonagenarians in the literature. CONCLUSION: octogenarians and nonagenarians receiving IVT have a similar safety outcome. Asian octogenarians and nonagenarians receiving IVT for ischaemic stroke are not at higher risk of symptomatic ICH and mortality than Western patients.