Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2890
Título: Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe
Autor: Pego, PM
Paiva Nunes, A
Ferreira, P
Sousa, C
Amaral-Silva, A
Palavras-chave: 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
Data: Jun-2016
Editora: WB Saunders
Citação: J Stroke Cerebrovasc Dis. 2016 Jun;25(6):1532-8.
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.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2890
DOI: 10.1016/j.jstrokecerebrovasdis.2016.03.007
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