Examining outcomes following thrombolysis in an increasingly older and dependent stroke population

Charlotte Algeo; Sean Beh; Lindsay McDonald; Angus D MacLeod; John M Reid

doi:10.4997/JRCPE.2020.405

Examining outcomes following thrombolysis in an increasingly older and dependent stroke population

Charlotte Algeo, Sean Beh, Lindsay McDonald, Angus D MacLeod, John M Reid^* (Corresponding Author)

^*Corresponding author for this work

School of Medicine, Medical Sciences & Nutrition

Research output: Contribution to journal › Article › peer-review

3 Citations (Scopus)

2 Downloads (Pure)

Abstract

BACKGROUND: Thrombolysis for acute ischaemic stroke (AIS) patients aged ˜80 years is evidence based, although its use in previously dependent patients is controversial.

METHODS: Data from 831 thrombolysed AIS patients in our centre from 2009-2017 were used to compare demographic trends and outcomes (haemorrhage, mortality, three-month independence) in patients aged <80 and ˜80 years and with prior dependency. Comparison with UK and world registry data regarding age and pre-stroke dependency was made.

RESULTS: The percentage of treated patients aged ˜80 years increased year-on-year, doubling from 25% to 50% (p <0.01), with increasing average age and pre-stroke dependency in world centres. Patients ˜80 years had higher (p <0.001) stroke severity, symptomatic intracerebral haemorrhage (5% vs. 1.5%), mortality (35% vs. 13%) and lower three month independent survival (24% vs. 60%). Patients with pre-stroke dependency had especially higher three month mortality (57-71%, OR 3.75 [95% CI 1.97-7.15]) in both age groups.

CONCLUSION: Patients aged ˜80 years and with dependency increasingly receive thrombolysis. Given poorer outcomes thrombolysis trials are needed in pre-stroke dependent patients.

Original language	English
Pages (from-to)	372-378
Number of pages	7
Journal	The journal of the Royal College of Physicians of Edinburgh
Volume	50
Issue number	4
DOIs	https://doi.org/10.4997/JRCPE.2020.405
Publication status	Published - 31 Dec 2020

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Cite this

@article{1042d24b92404c0a8a33f0ddb332f397,

title = "Examining outcomes following thrombolysis in an increasingly older and dependent stroke population",

abstract = "BACKGROUND: Thrombolysis for acute ischaemic stroke (AIS) patients aged ˜80 years is evidence based, although its use in previously dependent patients is controversial.METHODS: Data from 831 thrombolysed AIS patients in our centre from 2009-2017 were used to compare demographic trends and outcomes (haemorrhage, mortality, three-month independence) in patients aged <80 and ˜80 years and with prior dependency. Comparison with UK and world registry data regarding age and pre-stroke dependency was made.RESULTS: The percentage of treated patients aged ˜80 years increased year-on-year, doubling from 25% to 50% (p <0.01), with increasing average age and pre-stroke dependency in world centres. Patients ˜80 years had higher (p <0.001) stroke severity, symptomatic intracerebral haemorrhage (5% vs. 1.5%), mortality (35% vs. 13%) and lower three month independent survival (24% vs. 60%). Patients with pre-stroke dependency had especially higher three month mortality (57-71%, OR 3.75 [95% CI 1.97-7.15]) in both age groups.CONCLUSION: Patients aged ˜80 years and with dependency increasingly receive thrombolysis. Given poorer outcomes thrombolysis trials are needed in pre-stroke dependent patients.",

author = "Charlotte Algeo and Sean Beh and Lindsay McDonald and MacLeod, {Angus D} and Reid, {John M}",

note = "We are grateful for the support of the nurses from Chest, Heart and Stroke Scotland for assisting in obtaining follow-up functional status at three months.",

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doi = "10.4997/JRCPE.2020.405",

language = "English",

volume = "50",

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publisher = "Royal College of Physicians of Edinburgh",

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T1 - Examining outcomes following thrombolysis in an increasingly older and dependent stroke population

AU - Algeo, Charlotte

AU - Beh, Sean

AU - McDonald, Lindsay

AU - MacLeod, Angus D

AU - Reid, John M

N1 - We are grateful for the support of the nurses from Chest, Heart and Stroke Scotland for assisting in obtaining follow-up functional status at three months.

PY - 2020/12/31

Y1 - 2020/12/31

N2 - BACKGROUND: Thrombolysis for acute ischaemic stroke (AIS) patients aged ˜80 years is evidence based, although its use in previously dependent patients is controversial.METHODS: Data from 831 thrombolysed AIS patients in our centre from 2009-2017 were used to compare demographic trends and outcomes (haemorrhage, mortality, three-month independence) in patients aged <80 and ˜80 years and with prior dependency. Comparison with UK and world registry data regarding age and pre-stroke dependency was made.RESULTS: The percentage of treated patients aged ˜80 years increased year-on-year, doubling from 25% to 50% (p <0.01), with increasing average age and pre-stroke dependency in world centres. Patients ˜80 years had higher (p <0.001) stroke severity, symptomatic intracerebral haemorrhage (5% vs. 1.5%), mortality (35% vs. 13%) and lower three month independent survival (24% vs. 60%). Patients with pre-stroke dependency had especially higher three month mortality (57-71%, OR 3.75 [95% CI 1.97-7.15]) in both age groups.CONCLUSION: Patients aged ˜80 years and with dependency increasingly receive thrombolysis. Given poorer outcomes thrombolysis trials are needed in pre-stroke dependent patients.

AB - BACKGROUND: Thrombolysis for acute ischaemic stroke (AIS) patients aged ˜80 years is evidence based, although its use in previously dependent patients is controversial.METHODS: Data from 831 thrombolysed AIS patients in our centre from 2009-2017 were used to compare demographic trends and outcomes (haemorrhage, mortality, three-month independence) in patients aged <80 and ˜80 years and with prior dependency. Comparison with UK and world registry data regarding age and pre-stroke dependency was made.RESULTS: The percentage of treated patients aged ˜80 years increased year-on-year, doubling from 25% to 50% (p <0.01), with increasing average age and pre-stroke dependency in world centres. Patients ˜80 years had higher (p <0.001) stroke severity, symptomatic intracerebral haemorrhage (5% vs. 1.5%), mortality (35% vs. 13%) and lower three month independent survival (24% vs. 60%). Patients with pre-stroke dependency had especially higher three month mortality (57-71%, OR 3.75 [95% CI 1.97-7.15]) in both age groups.CONCLUSION: Patients aged ˜80 years and with dependency increasingly receive thrombolysis. Given poorer outcomes thrombolysis trials are needed in pre-stroke dependent patients.

U2 - 10.4997/JRCPE.2020.405

DO - 10.4997/JRCPE.2020.405

M3 - Article

C2 - 33469611

VL - 50

SP - 372

EP - 378

JO - Journal of the Royal College of Physicians of Edinburgh

JF - Journal of the Royal College of Physicians of Edinburgh

SN - 1478-2715

IS - 4

ER -

Examining outcomes following thrombolysis in an increasingly older and dependent stroke population

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