Capucine Diard-Detoeuf1, Séverine Debiais2, Mélanie Imbert2, Alexandra Musikas2, Marie Gaudron2, Emeline Laurent3, Bertrand De Toffol2, Caroline Hommet4,5, Karl Mondon4,5. 1. Department of Neurology, Hôpital Bretonneau, University Hospital of Tours, 2 boulevard Tonnellé, 37000, Tours, France. capucine.diarddetoeuf@gmail.com. 2. Department of Neurology, Hôpital Bretonneau, University Hospital of Tours, 2 boulevard Tonnellé, 37000, Tours, France. 3. Laboratory of Epidemiology and Public Health, Faculty of Medicine, François Rabelais University, Tours, France. 4. Department of Geriatrics and Memory Center, University Hospital of Tours, Tours, France. 5. UMR INSERM U930, François Rabelais University, Tours, France.
Abstract
INTRODUCTION: The use of intravenous thrombolysis with alteplase for ischemic stroke in Europe is restricted to subjects aged <80 years. Recent studies have reported the efficacy and safety of alteplase in older patients. However, data concerning the quality of life (QOL) of these elderly subjects are sparse. OBJECTIVES: The aim of this study was to compare the QOL of patients aged ≥80 years with that of patients aged <80 years at 3 months after thrombolysis. METHOD: This was a prospective study comprising French-speaking patients aged >18 years treated using thrombolytic therapy for ischemic stroke at the Hospital of Tours (Tours, France) between June 2012 and January 2013. QOL was assessed using the Stroke Impact Scale (SIS). The presence of mood disorders or cognitive impairments was also assessed. RESULTS: QOL was evaluated for 62 subjects among the 83 enrolled patients who received thrombolytic treatment; 21 patients were aged >80 years. Concerning scores on the SIS, using a multivariate analysis, only the memory and thinking score was significantly and negatively associated with the elderly population [odds ratio (OR) 0.036, 95% confidence interval (CI) 0.004-0.339; p = 0.004]. No significant difference was observed among all the other QOL scores. Neurological recovery and functional status did not differ between the two groups. CONCLUSION: QOL after intravenous thrombolysis in the elderly population was comparable to that of younger subjects. Despite its small sample size, this study showed promising results in favor of intravenous thrombolysis in the elderly population and highlighted the importance of systematic screening for post-stroke cognitive impairment, particularly in this population.
INTRODUCTION: The use of intravenous thrombolysis with alteplase for ischemic stroke in Europe is restricted to subjects aged <80 years. Recent studies have reported the efficacy and safety of alteplase in older patients. However, data concerning the quality of life (QOL) of these elderly subjects are sparse. OBJECTIVES: The aim of this study was to compare the QOL of patients aged ≥80 years with that of patients aged <80 years at 3 months after thrombolysis. METHOD: This was a prospective study comprising French-speaking patients aged >18 years treated using thrombolytic therapy for ischemic stroke at the Hospital of Tours (Tours, France) between June 2012 and January 2013. QOL was assessed using the Stroke Impact Scale (SIS). The presence of mood disorders or cognitive impairments was also assessed. RESULTS: QOL was evaluated for 62 subjects among the 83 enrolled patients who received thrombolytic treatment; 21 patients were aged >80 years. Concerning scores on the SIS, using a multivariate analysis, only the memory and thinking score was significantly and negatively associated with the elderly population [odds ratio (OR) 0.036, 95% confidence interval (CI) 0.004-0.339; p = 0.004]. No significant difference was observed among all the other QOL scores. Neurological recovery and functional status did not differ between the two groups. CONCLUSION: QOL after intravenous thrombolysis in the elderly population was comparable to that of younger subjects. Despite its small sample size, this study showed promising results in favor of intravenous thrombolysis in the elderly population and highlighted the importance of systematic screening for post-stroke cognitive impairment, particularly in this population.
Authors: Pedro Enrique Jiménez Caballero; Fidel López Espuela; Juan Carlos Portilla Cuenca; José María Ramírez Moreno; Juan Diego Pedrera Zamorano; Ignacio Casado Naranjo Journal: J Stroke Cerebrovasc Dis Date: 2013-01-22 Impact factor: 2.136
Authors: Werner Hacke; Geoffrey Donnan; Cesare Fieschi; Markku Kaste; Rüdiger von Kummer; Joseph P Broderick; Thomas Brott; Michael Frankel; James C Grotta; E Clarke Haley; Thomas Kwiatkowski; Steven R Levine; Chris Lewandowski; Mei Lu; Patrick Lyden; John R Marler; Suresh Patel; Barbara C Tilley; Gregory Albers; Erich Bluhmki; Manfred Wilhelm; Scott Hamilton Journal: Lancet Date: 2004-03-06 Impact factor: 79.321
Authors: Nishant K Mishra; Niaz Ahmed; Grethe Andersen; José A Egido; Perttu J Lindsberg; Peter A Ringleb; Nils G Wahlgren; Kennedy R Lees Journal: BMJ Date: 2010-11-23