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 ORIGINAL ARTICLE
Year : 2012  |  Volume : 60  |  Issue : 4  |  Page : 373--378

Efficacy and safety of thrombolysis in patients aged 80 years or above with major acute ischemic stroke


1 Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea
2 Departments of Neurology; Stroke Centre, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea

Correspondence Address:
Keun-Sik Hong
Departments of Neurology and Clinical Research Centre, Ilsan Paik Hospital, Inje University College of Medicine, 2240 Daehwa-dong, Ilsanseo-gu, Goyang
South Korea
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.100719

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Background: Elderly patients with major ischemic strokes may remain severely disabled or dead. However, efficacy and safety of thrombolysis in this have not been fully explored. Materials and Methods: Data from the case records of patients aged >80 years with acute ischemic stroke with admission National Institute of Health Stroke Scale (NIHSS) score ≥10 admitted between April 2009 and May 2011 were retrieved. Outcomes in patients treated with thrombolysis and control subjects were compared. Primary outcome was 3-month modified Rankin Scale (mRS) score 0-2. Secondary outcomes were 3-month mRS score 0-3, mRS score 5-6, mortality, and improvement NIHHS score at discharge. Safety outcome was hemorrhagic transformation. Results: Study subjects included 22 patients treated with thrombolysis and 23 controls not treated with thrombolysis. Age, stroke severity, and proportion of identified major vessel occlusions were the variables for comparison between the two groups. More patients in the thrombolyzed group had mRS 0-2 outcome than in non-thrombolyzed group (18.2% vs. 0%; P = 0.049). Proportion of patients with mRS 0-3 outcome was also higher in thrombolyzed group than in non-thrombolyzed group (22.7% vs. 0%; P = 0.022). Patients in the thrombolyzed group had higher mortality, non-significant when compared to patients in the non-thrombolyzed group (18.2% vs. 8.7%; P = 0.414). However, lesser number of patients in the thrombolyzed group had mRS 5-6 outcome (35% vs. 65%; P = 0.075). Median improvement in NIHSS score at discharge also showed a more favorable trend in thrombolyzed group (10 vs. 2; P = 0.082). Rates of symptomatic and asymptomatic hemorrhagic transformations in thrombolyzed group were 4.5% and 27.3% respectively. Conclusion: For elderly patients with major ischemic strokes, thrombolysis offers a greater chance of functional independence.






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