Wusheng Zhu1, Lulu Xiao2, Monica Lin3, Xinfeng Liu2, Bernard Yan4. 1. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China; Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia. 2. Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, Jiangsu Province, China. 3. Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia. 4. Department of Medicine and Neurology, Melbourne Brain Centre at the Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia. Electronic address: bernard.yan@mh.org.au.
Abstract
OBJECTIVE: We aimed to investigate the association between large-vessel occlusion (LVO) and functional outcome in elderly stroke patients treated with intravenous (IV) tissue plasminogen activator (tPA). METHODS: This was a retrospective study of acute ischemic stroke patients who received IV tPA within 4.5 hours after stroke onset between 2007 and 2013. Patients were categorized into 2 groups based on age (≥80 or < 80 years). LVO was evaluated by computed tomography angiography (CTA) before thrombolysis. Favorable outcome was defined as a modified Rankin Scale (mRS) score of 2 or lower at 3 months, or equal to the prestroke mRS score. RESULTS: Of 359 thrombolysis patients, 175 patients with CTA before a standard dose of IV tPA therapy (0.9 mg/kg body weight; maximum 90 mg) were included. Sixty-five patients were in the group aged 80 years or above with a median age of 84 (interquartile range: 82.5, 86) years. LVO was observed more often in the group with unfavorable outcome compared with the group with favorable outcome in older stroke patients (60.6% versus 21.9%, P = .002). The baseline National Institutes of Health Stroke Scale (NIHSS) score (odds ratio .864; 95% confidence interval [CI], .779-.959; P = .006) and LVO (odds ratio .233; 95% CI, .059-.930; P = .039) were independent associative factors for the unfavorable outcome in older patients treated with IV tPA after adjustment for patient characteristics. CONCLUSIONS: The baseline NIHSS score and LVO were independent predictors for functional outcome in elderly stroke patients received IV tPA.
OBJECTIVE: We aimed to investigate the association between large-vessel occlusion (LVO) and functional outcome in elderly strokepatients treated with intravenous (IV) tissue plasminogen activator (tPA). METHODS: This was a retrospective study of acute ischemic strokepatients who received IV tPA within 4.5 hours after stroke onset between 2007 and 2013. Patients were categorized into 2 groups based on age (≥80 or < 80 years). LVO was evaluated by computed tomography angiography (CTA) before thrombolysis. Favorable outcome was defined as a modified Rankin Scale (mRS) score of 2 or lower at 3 months, or equal to the prestroke mRS score. RESULTS: Of 359 thrombolysis patients, 175 patients with CTA before a standard dose of IV tPA therapy (0.9 mg/kg body weight; maximum 90 mg) were included. Sixty-five patients were in the group aged 80 years or above with a median age of 84 (interquartile range: 82.5, 86) years. LVO was observed more often in the group with unfavorable outcome compared with the group with favorable outcome in older strokepatients (60.6% versus 21.9%, P = .002). The baseline National Institutes of Health Stroke Scale (NIHSS) score (odds ratio .864; 95% confidence interval [CI], .779-.959; P = .006) and LVO (odds ratio .233; 95% CI, .059-.930; P = .039) were independent associative factors for the unfavorable outcome in older patients treated with IV tPA after adjustment for patient characteristics. CONCLUSIONS: The baseline NIHSS score and LVO were independent predictors for functional outcome in elderly strokepatients received IV tPA.
Authors: Volker Maus; Daniel Behme; Christoph Kabbasch; Jan Borggrefe; Ioannis Tsogkas; Omid Nikoubashman; Martin Wiesmann; Michael Knauth; Anastasios Mpotsaris; Marios Nikos Psychogios Journal: Clin Neuroradiol Date: 2017-02-13 Impact factor: 3.649
Authors: Justyna M Derbisz; Marcin Wnuk; Tadeusz Popiela; Jeremiasz Jagiełła; Roman Pułyk; Joanna Słowik; Tomasz Dziedzic; Wojciech Turaj; Agnieszka Słowik Journal: Pol J Radiol Date: 2021-06-11