Examining outcomes following thrombolysis in an increasingly older and dependent stroke population.

Autor:	Algeo C; Acute Stroke Unit, Aberdeen Royal Infirmary, Aberdeen, UK., Beh S; Acute Stroke Unit, Aberdeen Royal Infirmary, Aberdeen, UK., McDonald L; Acute Stroke Unit, Aberdeen Royal Infirmary, Aberdeen, UK., MacLeod AD; Division of Applied Health Sciences, University of Aberdeen, Aberdeen, UK., Reid JM; Acute Stroke Unit, Aberdeen Royal Infirmary, Aberdeen, UK, Email: john.reid2@nhs.scot.
Jazyk:	angličtina
Zdroj:	The journal of the Royal College of Physicians of Edinburgh [J R Coll Physicians Edinb] 2020 Dec; Vol. 50 (4), pp. 372-378.
DOI:	10.4997/JRCPE.2020.405
Abstrakt:	Background: Thrombolysis for acute ischaemic stroke (AIS) patients aged ˜80 years is evidence based, although its use in previously dependent patients is controversial. Methods: Data from 831 thrombolysed AIS patients in our centre from 2009-2017 were used to compare demographic trends and outcomes (haemorrhage, mortality, three-month independence) in patients aged <80 and ˜80 years and with prior dependency. Comparison with UK and world registry data regarding age and pre-stroke dependency was made. Results: The percentage of treated patients aged ˜80 years increased year-on-year, doubling from 25% to 50% (p <0.01), with increasing average age and pre-stroke dependency in world centres. Patients ˜80 years had higher (p <0.001) stroke severity, symptomatic intracerebral haemorrhage (5% vs. 1.5%), mortality (35% vs. 13%) and lower three month independent survival (24% vs. 60%). Patients with pre-stroke dependency had especially higher three month mortality (57-71%, OR 3.75 [95% CI 1.97-7.15]) in both age groups. Conclusion: Patients aged ˜80 years and with dependency increasingly receive thrombolysis. Given poorer outcomes thrombolysis trials are needed in pre-stroke dependent patients. Competing Interests: No conflict of interests declared
Databáze:	MEDLINE
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