Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe
Autor(a) principal: | |
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Data de Publicação: | 2016 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10400.17/2890 |
Resumo: | BACKGROUND: Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS: A retrospective observational study of patients who received intravenous thrombolysis in a stroke unit between January 1, 2009, and June 30, 2012, was conducted. Variables were compared between 2 subgroups (≤80 and >80 years). RESULTS: Overall, 512 patients underwent intravenous thrombolysis, of which 13.1% were over 80 years. The mean age was 65.4 years in the younger subgroup and 82.9 years in the older subgroup. Prior independence rates did not differ between the subgroups. Prevalence of atrial fibrillation and cardioembolic stroke was higher in the older subgroup (P = .004 and .026). Only 3% of the elderly with atrial fibrillation were taking oral anticoagulants. Symptoms-to-needle time was lower in the older subgroup (P = .048). Stroke severity was higher in patients over 80 years (P = .026). There was significant improvement in the National Institutes of Health Stroke Scale score 7 days after intravenous thrombolysis (P < .001) in both subgroups. The proportion of patients with 3 months' favorable outcome and independence, hemorrhagic transformation, and mortality rates were similar in both subgroups. CONCLUSIONS: Elderly patients' benefits and outcomes from intravenous thrombolysis treatment were identical to the younger subgroup without excess hemorrhagic transformation or mortality. These results favor the use of intravenous thrombolysis in patients over 80 years. |
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Thrombolysis in Patients Aged over 80 Years Is Equally Effective and SafeAdultAge FactorsAgedAged, 80 and overDisability EvaluationFemaleFibrinolytic AgentsHumansInfusions, IntravenousMaleMiddle AgedRecovery of FunctionRegistriesRetrospective StudiesRisk AssessmentRisk FactorsSeverity of Illness IndexStrokeTime FactorsTime-to-TreatmentTreatment OutcomeYoung AdultThrombolytic TherapyCHLC UCVBACKGROUND: Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS: A retrospective observational study of patients who received intravenous thrombolysis in a stroke unit between January 1, 2009, and June 30, 2012, was conducted. Variables were compared between 2 subgroups (≤80 and >80 years). RESULTS: Overall, 512 patients underwent intravenous thrombolysis, of which 13.1% were over 80 years. The mean age was 65.4 years in the younger subgroup and 82.9 years in the older subgroup. Prior independence rates did not differ between the subgroups. Prevalence of atrial fibrillation and cardioembolic stroke was higher in the older subgroup (P = .004 and .026). Only 3% of the elderly with atrial fibrillation were taking oral anticoagulants. Symptoms-to-needle time was lower in the older subgroup (P = .048). Stroke severity was higher in patients over 80 years (P = .026). There was significant improvement in the National Institutes of Health Stroke Scale score 7 days after intravenous thrombolysis (P < .001) in both subgroups. The proportion of patients with 3 months' favorable outcome and independence, hemorrhagic transformation, and mortality rates were similar in both subgroups. CONCLUSIONS: Elderly patients' benefits and outcomes from intravenous thrombolysis treatment were identical to the younger subgroup without excess hemorrhagic transformation or mortality. These results favor the use of intravenous thrombolysis in patients over 80 years.WB SaundersRepositório do Centro Hospitalar Universitário de Lisboa Central, EPEPego, PMPaiva Nunes, AFerreira, PSousa, CAmaral-Silva, A2018-02-06T16:11:51Z2016-062016-06-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.17/2890engJ Stroke Cerebrovasc Dis. 2016 Jun;25(6):1532-8.10.1016/j.jstrokecerebrovasdis.2016.03.007info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-03-10T09:40:11Zoai:repositorio.chlc.min-saude.pt:10400.17/2890Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T17:20:13.159891Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
title |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
spellingShingle |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe Pego, PM Adult Age Factors Aged Aged, 80 and over Disability Evaluation Female Fibrinolytic Agents Humans Infusions, Intravenous Male Middle Aged Recovery of Function Registries Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Stroke Time Factors Time-to-Treatment Treatment Outcome Young Adult Thrombolytic Therapy CHLC UCV |
title_short |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
title_full |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
title_fullStr |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
title_full_unstemmed |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
title_sort |
Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe |
author |
Pego, PM |
author_facet |
Pego, PM Paiva Nunes, A Ferreira, P Sousa, C Amaral-Silva, A |
author_role |
author |
author2 |
Paiva Nunes, A Ferreira, P Sousa, C Amaral-Silva, A |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Repositório do Centro Hospitalar Universitário de Lisboa Central, EPE |
dc.contributor.author.fl_str_mv |
Pego, PM Paiva Nunes, A Ferreira, P Sousa, C Amaral-Silva, A |
dc.subject.por.fl_str_mv |
Adult Age Factors Aged Aged, 80 and over Disability Evaluation Female Fibrinolytic Agents Humans Infusions, Intravenous Male Middle Aged Recovery of Function Registries Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Stroke Time Factors Time-to-Treatment Treatment Outcome Young Adult Thrombolytic Therapy CHLC UCV |
topic |
Adult Age Factors Aged Aged, 80 and over Disability Evaluation Female Fibrinolytic Agents Humans Infusions, Intravenous Male Middle Aged Recovery of Function Registries Retrospective Studies Risk Assessment Risk Factors Severity of Illness Index Stroke Time Factors Time-to-Treatment Treatment Outcome Young Adult Thrombolytic Therapy CHLC UCV |
description |
BACKGROUND: Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS: A retrospective observational study of patients who received intravenous thrombolysis in a stroke unit between January 1, 2009, and June 30, 2012, was conducted. Variables were compared between 2 subgroups (≤80 and >80 years). RESULTS: Overall, 512 patients underwent intravenous thrombolysis, of which 13.1% were over 80 years. The mean age was 65.4 years in the younger subgroup and 82.9 years in the older subgroup. Prior independence rates did not differ between the subgroups. Prevalence of atrial fibrillation and cardioembolic stroke was higher in the older subgroup (P = .004 and .026). Only 3% of the elderly with atrial fibrillation were taking oral anticoagulants. Symptoms-to-needle time was lower in the older subgroup (P = .048). Stroke severity was higher in patients over 80 years (P = .026). There was significant improvement in the National Institutes of Health Stroke Scale score 7 days after intravenous thrombolysis (P < .001) in both subgroups. The proportion of patients with 3 months' favorable outcome and independence, hemorrhagic transformation, and mortality rates were similar in both subgroups. CONCLUSIONS: Elderly patients' benefits and outcomes from intravenous thrombolysis treatment were identical to the younger subgroup without excess hemorrhagic transformation or mortality. These results favor the use of intravenous thrombolysis in patients over 80 years. |
publishDate |
2016 |
dc.date.none.fl_str_mv |
2016-06 2016-06-01T00:00:00Z 2018-02-06T16:11:51Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10400.17/2890 |
url |
http://hdl.handle.net/10400.17/2890 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
J Stroke Cerebrovasc Dis. 2016 Jun;25(6):1532-8. 10.1016/j.jstrokecerebrovasdis.2016.03.007 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
WB Saunders |
publisher.none.fl_str_mv |
WB Saunders |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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1799131298699149312 |