80세 이상 급성기 뇌졸중 환자에게 시행하는 정맥내 혈전용해치료: 단일 기관 예비연구
Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients Aged 80-Years or Older: A Single Center Pilot Study
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Background: Although the number of the elderly stroke patients increases, treatment with intravenous recombinant tissue plasminogen activator (rt-PA) is currently not recommended in the elderly. We investigated the safety and clinical outcome of the intravenous thrombolysis in the elderly. Methods: We consecutively enrolled patients who underwent intravenous rt-PA thrombolysis according to the treatment protocol based on the American heart association guidelines. The demographic data, initial national institutes of health stroke scale score and stroke subtype were assessed. The clinical outcomes were modified Rankin Scale (mRS) at 3 months. Symptomatic intracranial hemorrhage causing any neurological decline was evaluated. All clinical data were compared between patients who were 80 years or older and those less than 80 years. Results: Of the total 46 patients, 7 (15.2%) patients were 80 years or older. The baseline characteristics were comparable between both groups. Symptomatic hemorrhagic transformation was not different between both groups [0/7 (0%) vs. 3/39 (7.7%), P>0.999]. There was no difference in favorable outcome (mRS 0-2) and mortality between both groups [2/7 (28.6%) vs. 25/37 (67.6%), P=0.089, 1/7 (14.3%) vs. 4/37 (10.8%), P>0.999, respectively]. Conclusion: Symptomatic intracranial hemorrhage was not higher in the elderly and the favorable clinical outcome was comparable between the two groups. (Korean J Stroke 2010;12:102-105)
Abstract
Background: Although the number of the elderly stroke patients increases, treatment with intravenous recombinant tissue plasminogen activator (rt-PA) is currently not recommended in the elderly. We investigated the safety and clinical outcome of the intravenous thrombolysis in the elderly. Methods: We consecutively enrolled patients who underwent intravenous rt-PA thrombolysis according to the treatment protocol based on the American heart association guidelines. The demographic data, initial national institutes of health stroke scale score and stroke subtype were assessed. The clinical outcomes were modified Rankin Scale (mRS) at 3 months. Symptomatic intracranial hemorrhage causing any neurological decline was evaluated. All clinical data were compared between patients who were 80 years or older and those less than 80 years. Results: Of the total 46 patients, 7 (15.2%) patients were 80 years or older. The baseline characteristics were comparable between both groups. Symptomatic hemorrhagic transformation was not different between both groups [0/7 (0%) vs. 3/39 (7.7%), P>0.999]. There was no difference in favorable outcome (mRS 0-2) and mortality between both groups [2/7 (28.6%) vs. 25/37 (67.6%), P=0.089, 1/7 (14.3%) vs. 4/37 (10.8%), P>0.999, respectively]. Conclusion: Symptomatic intracranial hemorrhage was not higher in the elderly and the favorable clinical outcome was comparable between the two groups. (Korean J Stroke 2010;12:102-105)
참고문헌 (14)
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