Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand.
J Stroke Cerebrovasc Dis. 2013 Apr;22(3):227-31. doi: 10.1016/j.jstrokecerebrovasdis.2011.08.001. Epub 2011 Dec 15.
Intravenous thrombolysis is a standard treatment in eligible acute ischemic stroke (AIS) patients. However, the advisability of treating patients >80 years of age is still debated. The aim of this study was to evaluate the role of aging on the outcomes in Thai patients treated with intravenous thrombolysis.
Patients with AIS treated with intravenous recombinant tissue-plasminogen activator (rtPA) between June 2007 and November 2010 were included. The demographics and measured outcome variables were compared between patients ≤70 and >70 years of age. Patients were also classified into 4 subgroups by the age ranges: ≤60 years, 61 to 70 years, 71 to 80 years, and ≥81 years of age.
Two hundred sixty-one patients were included. Seventeen patients (6.5%) were >80 years old. Higher mortality (20.2% vs 5.1%; P < .001) and symptomatic intracerebral hemorrhage (7.7% vs 1.2%; P = .004) were found in the patients >70 years of age when compared with younger patients, and the rate of favorable outcome was lower (38.1% vs 55.4%; P = .010). Higher mortality rates were seen with increasing age: 3%, 8%, 20%, and 21% in patients aged ≤60, 61 to 70, 71 to 80, and ≥81 years of age, respectively.
Thai stroke patients >70 years of age may carry a higher risk of mortality when treated with intravenous rtPA compared to patients ≤70 years of age.
静脉溶栓治疗是符合条件的急性缺血性脑卒中（AIS）患者的标准治疗方法。然而，治疗 80 岁以上患者的适宜性仍存在争议。本研究旨在评估年龄对泰国接受静脉溶栓治疗的 AIS 患者结局的影响。
纳入 2007 年 6 月至 2010 年 11 月期间接受静脉重组组织型纤溶酶原激活剂（rtPA）治疗的 AIS 患者。比较了≤70 岁和>70 岁患者的人口统计学和测量结果变量。患者还根据年龄范围分为 4 个亚组：≤60 岁、61 至 70 岁、71 至 80 岁和≥81 岁。
共纳入 261 例患者，其中 17 例（6.5%）>80 岁。与年轻患者相比，年龄>70 岁的患者死亡率更高（20.2%对 5.1%；P<0.001），症状性颅内出血发生率更高（7.7%对 1.2%；P=0.004），且预后良好的比例较低（38.1%对 55.4%；P=0.010）。随着年龄的增加，死亡率也随之增加：年龄≤60 岁、61 至 70 岁、71 至 80 岁和≥81 岁的患者死亡率分别为 3%、8%、20%和 21%。
与≤70 岁的患者相比，泰国接受静脉 rtPA 治疗的>70 岁 AIS 患者的死亡率可能更高。
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