Stroke Research Today is a free monthly online journal that collates and summarizes the latest research about Stroke, including details on treatment, recovery, rehabilitation, signs, symptoms.

Thrombolysis for acute stroke with special emphasis on the very old: experience from a single Dutch centre.

van Oostenbrugge RJ, Hupperts RM, Lodder J

Department of Neurology, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands. rvoo@sneu.azm.nl

The aim of this study was to describe the clinical experience in 184 consecutive stroke patients first-ever treated with recombinant tissue plasminogen activator (rt-PA) at a single Dutch centre, with special emphasis on results among the very old. Outcome parameters were the modified Rankin scale (mRs) at 3 months and symptomatic intracranial haemorrhage (SICH). Outcome was related to age. A total of 184 patients were treated of whom 45 were 80 years of age or older (24%). Sixty two (45%) of 139 patients < 80 years of age and 12 (27%) of 45 patients > or = 80 years of age had a favourable outcome defined as an mRs score of 0 or 1 (OR 2.21; 95% CI: 1.06 to 4.46). There was a good outcome (mRs score < or = 2) in 88 (63%) and 16 (36%) patients, respectively (OR 3.13; 95% CI: 1.55 to 6.30). SICH was observed in four of 139 (2.9%) patients < 80 years of age and in five of 45 (11.1%) patients > or = 80 years of age (OR 4.22; 95% CI: 1.08 to 16.46). The results of this study underline the uncertainty regarding the risk/benefit ratio of rt-PA treatment in acute stroke in patients over 80 years of age.

Published 17 February 2006 in J Neurol Neurosurg Psychiatry, 77(3): 375-7.
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