Outcomes of thrombolysis for acute ischemic stroke in octogenarians versus nonagenarians.

Farrah J Mateen, Alastair M Buchan, Michael D Hill, CASES Investigators
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Abstract

BACKGROUND AND PURPOSE: Little is reported on the outcomes of nonagenarians who are treated with intravenous tissue plasminogen activator for acute ischemic Stroke. It is uncertain whether nonagenarians have higher mortality and worse functional outcomes than octogenarians.
METHODS: All patients who were >or=80 years of age were extracted from the Canadian Activase for Stroke Effectiveness Study national registry, a 60-center Canadian acute ischemic Stroke treatment network. patients were divided into 2 groups: those who were 80 to 89 years of age (octogenarians) and those who were 90 to 99 years of age (nonagenarians), and compared by baseline clinical, demographic, treatment, and outcome-related measures.
RESULTS: Twenty-eight nonagenarians and 242 octogenarians were treated with intravenous tissue plasminogen activator for acute ischemic Stroke over the 2.5-year observation period. Nonagenarians and octogenarians did not differ on any of the baseline clinical or demographic variables. Both groups were predominantly female (77% nonagenarians and 61% octogenarians), hypertensive (54% and 60%), and predominantly had severe strokes (National Institutes of Health Stroke Scale score >15; 58% and 52%). The rate of symptomatic intracerebral hemorrhage (7% nonagenarians versus 4% octogenarians; P=0.359), 90-day mortality (52% versus 33%; P=0.087), and 30-day favorable functional outcomes ([modified Rankin score CONCLUSIONS: There is no significant difference in 90-day mortality, 30-day functional outcome, or rate of symptomatic intracerebral hemorrhage between nonagenarians and octogenarians treated with intravenous tissue plasminogen activator when comparing populations of similar baseline risk.

MeSH Term

Age Factors
Aged, 80 and over
Brain Ischemia
Canada
Female
Fibrinolytic Agents
Humans
Male
Registries
Stroke
Thrombolytic Therapy
Tissue Plasminogen Activator
Treatment Outcome

Chemicals

Fibrinolytic Agents
Tissue Plasminogen Activator

Word Cloud

Created with Highcharts 10.0.0nonagenariansoctogenariansacuteischemicstrokeageversusoutcomestreatedintravenoustissueplasminogenactivatormortalityfunctionalyears2baselineP=0CanadianStroketreatmentclinicaldemographicgroupspredominantlyscore52%ratesymptomaticintracerebralhemorrhage90-day30-daysignificantdifferencecomparingBACKGROUNDANDPURPOSE:LittlereporteduncertainwhetherhigherworseMETHODS:patients>or=80extractedActivaseEffectivenessStudynationalregistry60-centernetworkPatientsdividedgroups:80899099comparedoutcome-relatedmeasuresRESULTS:Twenty-eight2425-yearobservationperiodNonagenariansdiffervariablesfemale77%61%hypertensive54%60%severestrokesNationalInstitutesHealthScale>1558%7%4%35933%087favorable[modifiedRankin30%26%647showedstatisticallyCONCLUSIONS:outcomepopulationssimilarriskOutcomesthrombolysis

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