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...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Xuya Huang, Phillip Nash, Vafa Alakbarzade, Brian Clarke, Anthony C. Pereira
Formato:	article
Lenguaje:	EN
Publicado:	Hindawi Limited 2021
Materias:	Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/ddcc84811de64e1e9d19f274fa242be7
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:ddcc84811de64e1e9d19f274fa242be7
record_format	dspace
spelling	oai:doaj.org-article:ddcc84811de64e1e9d19f274fa242be72021-11-08T02:36:10ZClinical 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 20182042-005610.1155/2021/3738017https://doaj.org/article/ddcc84811de64e1e9d19f274fa242be72021-01-01T00:00:00Zhttp://dx.doi.org/10.1155/2021/3738017https://doaj.org/toc/2042-0056Intravenous 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<0.0001). In conclusion, thrombolysis in elderly patients results in clinical improvement comparable to younger patients.Xuya HuangPhillip NashVafa AlakbarzadeBrian ClarkeAnthony C. PereiraHindawi LimitedarticleNeurology. Diseases of the nervous systemRC346-429ENStroke Research and Treatment, Vol 2021 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Neurology. Diseases of the nervous system RC346-429
spellingShingle	Neurology. Diseases of the nervous system RC346-429 Xuya Huang Phillip Nash Vafa Alakbarzade Brian Clarke Anthony C. Pereira 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
description	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<0.0001). In conclusion, thrombolysis in elderly patients results in clinical improvement comparable to younger patients.
format	article
author	Xuya Huang Phillip Nash Vafa Alakbarzade Brian Clarke Anthony C. Pereira
author_facet	Xuya Huang Phillip Nash Vafa Alakbarzade Brian Clarke Anthony C. Pereira
author_sort	Xuya Huang
title	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
title_short	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
title_full	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
title_fullStr	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
title_full_unstemmed	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
title_sort	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
publisher	Hindawi Limited
publishDate	2021
url	https://doaj.org/article/ddcc84811de64e1e9d19f274fa242be7
work_keys_str_mv	AT xuyahuang clinicaloutcomesafterintravenousalteplaseinelderlypatientswithacuteischaemicstrokearetrospectiveanalysisofpatientstreatedatatertiaryneurologycentreinenglandfrom2013to2018 AT phillipnash clinicaloutcomesafterintravenousalteplaseinelderlypatientswithacuteischaemicstrokearetrospectiveanalysisofpatientstreatedatatertiaryneurologycentreinenglandfrom2013to2018 AT vafaalakbarzade clinicaloutcomesafterintravenousalteplaseinelderlypatientswithacuteischaemicstrokearetrospectiveanalysisofpatientstreatedatatertiaryneurologycentreinenglandfrom2013to2018 AT brianclarke clinicaloutcomesafterintravenousalteplaseinelderlypatientswithacuteischaemicstrokearetrospectiveanalysisofpatientstreatedatatertiaryneurologycentreinenglandfrom2013to2018 AT anthonycpereira clinicaloutcomesafterintravenousalteplaseinelderlypatientswithacuteischaemicstrokearetrospectiveanalysisofpatientstreatedatatertiaryneurologycentreinenglandfrom2013to2018
_version_	1718443143992442880

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

Ejemplares similares