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Elderly Patients Are at Higher Risk for Poor Outcomes After Intra-Arterial Therapy
- Source :
- Stroke. 43:2356-2361
- Publication Year :
- 2012
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2012.
-
Abstract
- Background and Purpose— Conflicting data exist regarding outcomes after intra-arterial therapy (IAT) in elderly stroke patients. We compare safety and clinical outcomes of multimodal IAT in elderly versus nonelderly patients and investigate differences in baseline health and disability as possible explanatory factors. Methods— Data from a prospectively collected institutional IAT database were analyzed comparing elderly (80 years or older) versus nonelderly patients. Baseline demographics, angiographic reperfusion (Thrombolysis in Cerebral Infarction scale score 2–3), rate of parenchymal hematoma type 2, and 90-day modified Rankin Scale scores were compared in univariate and multivariate analyses. Results— There were 49 elderly and 130 nonelderly patients treated between 2005 and 2010. Between the 2 cohorts, there was no significant difference in Thrombolysis in Cerebral Infarction 2 to 3 reperfusion (71% vs 75%; P =0.57), time to reperfusion ( P =0.77), or rate of parenchymal hematoma type 2 (4% vs 7%; P =0.73) after IAT. However, elderly patients had significantly lower rates of good outcome (modified Rankin Scale score 0–2: 2% vs 33%; P P P =0.003). Conclusions— Despite comparable rates of reperfusion and significant hemorrhage, elderly patients had worse clinical outcomes after IAT, which may relate, in part, to worse baseline health and disability. The use of IAT in the elderly should be performed after a careful analysis of the potential risks and benefits.
- Subjects :
- Male
Risk
medicine.medical_specialty
Endpoint Determination
medicine.medical_treatment
Cohort Studies
Coronary artery disease
Fibrinolytic Agents
Modified Rankin Scale
Internal medicine
Humans
Medicine
Thrombolytic Therapy
Prospective Studies
Stroke
Aged
Aged, 80 and over
Advanced and Specialized Nursing
business.industry
Cerebral infarction
Endovascular Procedures
Age Factors
Atrial fibrillation
Cerebral Infarction
Thrombolysis
Odds ratio
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Confidence interval
Surgery
Treatment Outcome
Injections, Intra-Arterial
Tissue Plasminogen Activator
Reperfusion
Female
Stents
Neurology (clinical)
Tomography, X-Ray Computed
Cardiology and Cardiovascular Medicine
business
Angioplasty, Balloon
Subjects
Details
- ISSN :
- 15244628 and 00392499
- Volume :
- 43
- Database :
- OpenAIRE
- Journal :
- Stroke
- Accession number :
- edsair.doi.dedup.....6b7bb172772a33713b07e7a60f5a8f80