Abstract
Objective: To study the short and long term differences in outcome between patients ≥80 years of age and those ≤79 years of age who received intravenous recombinant tissue plasminogen activator (iv rt-PA) for acute stroke within the first 3 hours of symptom onset. Methods: We studied consecutive patients treated with iv rt-PA for acute stroke, with prospective follow up of up to 3 years. Outcome measures included National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI), modified Rankin score (MRS), and stroke mortality. Patients were split into two groups: younger (≤79 years) and older (≥80 years). Results: There were 65 patients in the younger cohort and 31 patients in the older. Older patients were more likely to present with more severe baseline stroke (p = 0.04; odds ratio (OR) 3.04; 95% confidence interval (CI) 1.03 to 8.98). Stroke mortality at 90 days was 10.8% in the younger and 32.3% in the older cohort (p = 0.01). At 90 days' follow up, patients in the older cohort with more severe stroke (NIHSS score ≥11) were nearly 10 times more likely to have poor outcome compared with their younger counterparts presenting with severe stroke (p = 0.001; OR = 10.36; 95% CI 2.16 to 49.20). Baseline stroke severity and age were the only independent and equal predictors for stroke outcome. No threshold was found for age or baseline stroke severity predicting outcome. Conclusion: Older patients presenting with more severe baseline stroke are much less likely to benefit from iv rt-PA as compared with their younger counterparts.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1234-1237 |
| Number of pages | 4 |
| Journal | Journal of Neurology, Neurosurgery and Psychiatry |
| Volume | 76 |
| Issue number | 9 |
| DOIs | |
| State | Published - Sep 2005 |
| Externally published | Yes |
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ASJC Scopus subject areas
- Neuropsychology and Physiological Psychology
- Neuroscience(all)
- Psychiatry and Mental health
Cite this
Intravenous rt-PA for acute stroke : Comparing its effectiveness in younger and older patients. / Mouradian, M. S.; Senthilselvan, A.; Jickling, G.; McCombe, J. A.; Emery, D. J.; Dean, N.; Shuaib, A.
In: Journal of Neurology, Neurosurgery and Psychiatry, Vol. 76, No. 9, 09.2005, p. 1234-1237.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Intravenous rt-PA for acute stroke
T2 - Comparing its effectiveness in younger and older patients
AU - Mouradian, M. S.
AU - Senthilselvan, A.
AU - Jickling, G.
AU - McCombe, J. A.
AU - Emery, D. J.
AU - Dean, N.
AU - Shuaib, A.
PY - 2005/9
Y1 - 2005/9
N2 - Objective: To study the short and long term differences in outcome between patients ≥80 years of age and those ≤79 years of age who received intravenous recombinant tissue plasminogen activator (iv rt-PA) for acute stroke within the first 3 hours of symptom onset. Methods: We studied consecutive patients treated with iv rt-PA for acute stroke, with prospective follow up of up to 3 years. Outcome measures included National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI), modified Rankin score (MRS), and stroke mortality. Patients were split into two groups: younger (≤79 years) and older (≥80 years). Results: There were 65 patients in the younger cohort and 31 patients in the older. Older patients were more likely to present with more severe baseline stroke (p = 0.04; odds ratio (OR) 3.04; 95% confidence interval (CI) 1.03 to 8.98). Stroke mortality at 90 days was 10.8% in the younger and 32.3% in the older cohort (p = 0.01). At 90 days' follow up, patients in the older cohort with more severe stroke (NIHSS score ≥11) were nearly 10 times more likely to have poor outcome compared with their younger counterparts presenting with severe stroke (p = 0.001; OR = 10.36; 95% CI 2.16 to 49.20). Baseline stroke severity and age were the only independent and equal predictors for stroke outcome. No threshold was found for age or baseline stroke severity predicting outcome. Conclusion: Older patients presenting with more severe baseline stroke are much less likely to benefit from iv rt-PA as compared with their younger counterparts.
AB - Objective: To study the short and long term differences in outcome between patients ≥80 years of age and those ≤79 years of age who received intravenous recombinant tissue plasminogen activator (iv rt-PA) for acute stroke within the first 3 hours of symptom onset. Methods: We studied consecutive patients treated with iv rt-PA for acute stroke, with prospective follow up of up to 3 years. Outcome measures included National Institutes of Health Stroke Scale (NIHSS) score, Barthel Index (BI), modified Rankin score (MRS), and stroke mortality. Patients were split into two groups: younger (≤79 years) and older (≥80 years). Results: There were 65 patients in the younger cohort and 31 patients in the older. Older patients were more likely to present with more severe baseline stroke (p = 0.04; odds ratio (OR) 3.04; 95% confidence interval (CI) 1.03 to 8.98). Stroke mortality at 90 days was 10.8% in the younger and 32.3% in the older cohort (p = 0.01). At 90 days' follow up, patients in the older cohort with more severe stroke (NIHSS score ≥11) were nearly 10 times more likely to have poor outcome compared with their younger counterparts presenting with severe stroke (p = 0.001; OR = 10.36; 95% CI 2.16 to 49.20). Baseline stroke severity and age were the only independent and equal predictors for stroke outcome. No threshold was found for age or baseline stroke severity predicting outcome. Conclusion: Older patients presenting with more severe baseline stroke are much less likely to benefit from iv rt-PA as compared with their younger counterparts.
UR - http://www.scopus.com/inward/record.url?scp=23944440095&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=23944440095&partnerID=8YFLogxK
U2 - 10.1136/jnnp.2004.047803
DO - 10.1136/jnnp.2004.047803
M3 - Article
C2 - 16107357
AN - SCOPUS:23944440095
VL - 76
SP - 1234
EP - 1237
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
SN - 0022-3050
IS - 9
ER -