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Thrombolysis in Patients Aged over 80 Years Is Equally Effective and Safe

2016-06Journal article Open access
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dc.contributor.authorPego, PM
dc.contributor.authorPaiva Nunes, A
dc.contributor.authorFerreira, P
dc.contributor.authorSousa, C
dc.contributor.authorAmaral-Silva, A
dc.date.accessioned2018-02-06T16:11:51Z
dc.date.available2018-02-06T16:11:51Z
dc.date.issued2016-06
dc.description.abstractBACKGROUND: Despite stroke's high prevalence in the elderly, intravenous thrombolysis is licensed in Europe only for patients younger than 80 years old. We aimed to compare the functional outcomes and complication rates in patients older versus younger than 80 years old treated with intravenous thrombolysis. METHODS: A retrospective observational study of patients who received intravenous thrombolysis in a stroke unit between January 1, 2009, and June 30, 2012, was conducted. Variables were compared between 2 subgroups (≤80 and >80 years). RESULTS: Overall, 512 patients underwent intravenous thrombolysis, of which 13.1% were over 80 years. The mean age was 65.4 years in the younger subgroup and 82.9 years in the older subgroup. Prior independence rates did not differ between the subgroups. Prevalence of atrial fibrillation and cardioembolic stroke was higher in the older subgroup (P = .004 and .026). Only 3% of the elderly with atrial fibrillation were taking oral anticoagulants. Symptoms-to-needle time was lower in the older subgroup (P = .048). Stroke severity was higher in patients over 80 years (P = .026). There was significant improvement in the National Institutes of Health Stroke Scale score 7 days after intravenous thrombolysis (P < .001) in both subgroups. The proportion of patients with 3 months' favorable outcome and independence, hemorrhagic transformation, and mortality rates were similar in both subgroups. CONCLUSIONS: Elderly patients' benefits and outcomes from intravenous thrombolysis treatment were identical to the younger subgroup without excess hemorrhagic transformation or mortality. These results favor the use of intravenous thrombolysis in patients over 80 years.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Stroke Cerebrovasc Dis. 2016 Jun;25(6):1532-8.pt_PT
dc.identifier.doi10.1016/j.jstrokecerebrovasdis.2016.03.007pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/2890
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWB Saunderspt_PT
dc.subjectAdultpt_PT
dc.subjectAge Factorspt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectDisability Evaluationpt_PT
dc.subjectFemalept_PT
dc.subjectFibrinolytic Agentspt_PT
dc.subjectHumanspt_PT
dc.subjectInfusions, Intravenouspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectRecovery of Functionpt_PT
dc.subjectRegistriespt_PT
dc.subjectRetrospective Studiespt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectStrokept_PT
dc.subjectTime Factorspt_PT
dc.subjectTime-to-Treatmentpt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectYoung Adultpt_PT
dc.subjectThrombolytic Therapypt_PT
dc.subjectCHLC UCVpt_PT
dc.titleThrombolysis in Patients Aged over 80 Years Is Equally Effective and Safept_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1538pt_PT
oaire.citation.issue6pt_PT
oaire.citation.startPage1532pt_PT
oaire.citation.titleJournal of Stroke and Cerebrovascular Diseasespt_PT
oaire.citation.volume25pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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