Intravenous thrombolysis in Thai patients with acute ischemic stroke: role of aging

J Stroke Cerebrovasc Dis. 2013 Apr;22(3):227-31. doi: 10.1016/j.jstrokecerebrovasdis.2011.08.001. Epub 2011 Dec 15.

Abstract

Background: Intravenous thrombolysis is a standard treatment in eligible acute ischemic stroke (AIS) patients. However, the advisability of treating patients >80 years of age is still debated. The aim of this study was to evaluate the role of aging on the outcomes in Thai patients treated with intravenous thrombolysis.

Methods: Patients with AIS treated with intravenous recombinant tissue-plasminogen activator (rtPA) between June 2007 and November 2010 were included. The demographics and measured outcome variables were compared between patients ≤70 and >70 years of age. Patients were also classified into 4 subgroups by the age ranges: ≤60 years, 61 to 70 years, 71 to 80 years, and ≥81 years of age.

Results: Two hundred sixty-one patients were included. Seventeen patients (6.5%) were >80 years old. Higher mortality (20.2% vs 5.1%; P < .001) and symptomatic intracerebral hemorrhage (7.7% vs 1.2%; P = .004) were found in the patients >70 years of age when compared with younger patients, and the rate of favorable outcome was lower (38.1% vs 55.4%; P = .010). Higher mortality rates were seen with increasing age: 3%, 8%, 20%, and 21% in patients aged ≤60, 61 to 70, 71 to 80, and ≥81 years of age, respectively.

Conclusions: Thai stroke patients >70 years of age may carry a higher risk of mortality when treated with intravenous rtPA compared to patients ≤70 years of age.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intravenous
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Asian People
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / ethnology
  • Brain Ischemia / mortality
  • Cerebral Hemorrhage / chemically induced
  • Cerebral Hemorrhage / ethnology
  • Cerebral Hemorrhage / mortality
  • Chi-Square Distribution
  • Fibrinolytic Agents / administration & dosage*
  • Fibrinolytic Agents / adverse effects
  • Humans
  • Middle Aged
  • Recombinant Proteins / administration & dosage
  • Risk Assessment
  • Risk Factors
  • Stroke / drug therapy*
  • Stroke / ethnology
  • Stroke / mortality
  • Thailand / epidemiology
  • Thrombolytic Therapy* / adverse effects
  • Thrombolytic Therapy* / mortality
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Tissue Plasminogen Activator / adverse effects
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Recombinant Proteins
  • Tissue Plasminogen Activator