Clinical Outcomes after Intravenous Alteplase in Elderly Patients with Acute Ischaemic Stroke: A Retrospective Analysis of Patients Treated at a Tertiary Neurology Centre in England from 2013 to 2018

Intravenous thrombolysis with alteplase within 4.5 hours from symptom onset is a well-established treatment of acute ischaemic stroke (AIS). The aim was to compare alteplase for AIS between patients aged >80 and ≤80 years in our registry data, from 2013 to 2018. Mechanical thrombectomy cases were...

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Bibliographic Details
Published in:Stroke research and treatment 2021, Vol.2021, p.1-6
Main Authors: Huang, Xuya, Nash, Phillip, Alakbarzade, Vafa, Clarke, Brian, Pereira, Anthony C.
Format: Article
Language:English
Subjects:
Age groups
Aged patients
Cardiac arrhythmia
Care and treatment
Clinical outcomes
Diabetes
Heart failure
Hypertension
Ischemia
Mortality
Older people
Patient outcomes
Patients
Regression analysis
Stroke
Stroke (Disease)
Tissue plasminogen activator
Transient ischemic attack
United Kingdom
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Summary:Intravenous thrombolysis with alteplase within 4.5 hours from symptom onset is a well-established treatment of acute ischaemic stroke (AIS). The aim was to compare alteplase for AIS between patients aged >80 and ≤80 years in our registry data, from 2013 to 2018. Mechanical thrombectomy cases were excluded. We assessed clinical outcomes over the six-year period and between patients aged over 80 and ≤80 years, using measures including the discharge modified Rankin Scale (mRS), 24-hour National Institutes of Health Stroke Scale (NIHSS) improvement, and symptomatic intracerebral haemorrhage (sICH) rate. Of a total of 805 AIS patients who received intravenous alteplase, 278 (34.5%) were over 80 years old, and 527 (65%) were younger. 616 (76.5%) received thrombolysis≤3 hours after symptom onset and 189 (23.5%) within 3-4.5 hours. Median baseline mRS and NIHSS of the elderly cohort were 1 (IQR 0-5) and 13 (IQR 2-37), respectively, compared to the younger cohort 0 (IQR 0-5) and 9 (IQR 0-29). The sICH rate was 7.2% in the elderly and 4.6% in those ≤80 years, p=0.05. NIHSS improved within 24 hours in 34% of the elderly cohort compared to 35% in the younger cohort. At hospital discharge, the mortality rate was 9% in the elderly cohort compared to the 6% in the younger cohort, p=0.154. 25% of patients aged >80 years had mRS≤2 compared to 47% in the younger patients (p
ISSN:2090-8105
2042-0056
2042-0056
DOI:10.1155/2021/3738017