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Related Experiment Videos

Acute stroke management in the elderly.

Neer Zeevi1, Jyoti Chhabra, Isaac E Silverman

  • 1Department of Neurology, Hartford Hospital, Hartford, Connecticut, USA.

Cerebrovascular Diseases (Basel, Switzerland)
|January 3, 2007
PubMed
Summary
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Elderly patients over 80 with acute ischemic stroke (AIS) can safely receive recombinant tissue plasminogen activator (rtPA) treatment. This effective therapy improves outcomes and should not be withheld based solely on age.

Area of Science:

  • Neurology
  • Geriatrics
  • Emergency Medicine

Background:

  • Increasing proportion of elderly patients experiencing strokes.
  • Exclusion of patients over 80 from many clinical stroke trials.
  • Need to assess rtPA in older populations in community settings.

Purpose of the Study:

  • Review management of acute ischemic stroke (AIS) in patients over 80.
  • Assess safety and efficacy of recombinant tissue plasminogen activator (rtPA) in this demographic.
  • Compare outcomes of rtPA treatment in elderly vs. younger stroke patients.

Main Methods:

  • Retrospective review of 341 patients >80 years and 690 younger patients with AIS.
  • Comparison of NIH Stroke Scale (NIHSS) scores, thrombolytic treatment rates, and rtPA complications.

Related Experiment Videos

  • Assessment of Barthel Index at 12 months post-treatment.

    • Main Results:

    • Older patients (≥80) received rtPA at similar rates to younger patients, despite some being excluded for non-traditional reasons.
    • No increased risk of intracranial hemorrhage in older patients treated with rtPA.
    • Both age groups showed NIHSS improvement; elderly patients had comparable 12-month Barthel Index scores.

    Conclusions:

    • Recombinant tissue plasminogen activator (rtPA) treatment is safe and effective for patients over 80 with acute ischemic stroke (AIS).
    • rtPA therapy leads to acute and chronic improvements, including NIHSS decrease and sustained Barthel Index scores.
    • Age alone should not be a reason to withhold rtPA; further investigation into exclusions for elderly patients is warranted.