Diard-Detoeuf Capucine, Debiais Séverine, Imbert Mélanie, Musikas Alexandra, Gaudron Marie, Laurent Emeline, De Toffol Bertrand, Hommet Caroline, Mondon Karl
Department of Neurology, Hôpital Bretonneau, University Hospital of Tours, 2 boulevard Tonnellé, 37000, Tours, France.
Laboratory of Epidemiology and Public Health, Faculty of Medicine, François Rabelais University, Tours, France.
Drugs Aging. 2015 Nov;32(11):917-26. doi: 10.1007/s40266-015-0307-4.
The use of intravenous thrombolysis with alteplase for ischemic stroke in Europe is restricted to subjects aged <80 years. Recent studies have reported the efficacy and safety of alteplase in older patients. However, data concerning the quality of life (QOL) of these elderly subjects are sparse.
The aim of this study was to compare the QOL of patients aged ≥80 years with that of patients aged <80 years at 3 months after thrombolysis.
This was a prospective study comprising French-speaking patients aged >18 years treated using thrombolytic therapy for ischemic stroke at the Hospital of Tours (Tours, France) between June 2012 and January 2013. QOL was assessed using the Stroke Impact Scale (SIS). The presence of mood disorders or cognitive impairments was also assessed.
QOL was evaluated for 62 subjects among the 83 enrolled patients who received thrombolytic treatment; 21 patients were aged >80 years. Concerning scores on the SIS, using a multivariate analysis, only the memory and thinking score was significantly and negatively associated with the elderly population [odds ratio (OR) 0.036, 95% confidence interval (CI) 0.004-0.339; p = 0.004]. No significant difference was observed among all the other QOL scores. Neurological recovery and functional status did not differ between the two groups.
QOL after intravenous thrombolysis in the elderly population was comparable to that of younger subjects. Despite its small sample size, this study showed promising results in favor of intravenous thrombolysis in the elderly population and highlighted the importance of systematic screening for post-stroke cognitive impairment, particularly in this population.
在欧洲，使用阿替普酶进行静脉溶栓治疗缺血性卒中仅限于年龄小于80岁的患者。最近的研究报告了阿替普酶在老年患者中的疗效和安全性。然而，关于这些老年患者生活质量（QOL）的数据却很少。
本研究的目的是比较年龄≥80岁的患者与年龄<80岁的患者在溶栓后3个月时的生活质量。
这是一项前瞻性研究，纳入了2012年6月至2013年1月期间在法国图尔医院接受缺血性卒中溶栓治疗的年龄>18岁的法语患者。使用卒中影响量表（SIS）评估生活质量。还评估了情绪障碍或认知障碍的存在情况。
在83名接受溶栓治疗的入组患者中，对62名患者进行了生活质量评估；其中21名患者年龄>80岁。关于SIS评分，通过多变量分析，只有记忆和思维评分与老年人群显著负相关[比值比（OR）0.036，95%置信区间（CI）0.004 - 0.339；p = 0.004]。在所有其他生活质量评分中未观察到显著差异。两组之间的神经功能恢复和功能状态没有差异。
老年人群静脉溶栓后的生活质量与年轻患者相当。尽管样本量较小，但本研究显示了支持老年人群静脉溶栓的有前景的结果，并强调了对卒中后认知障碍进行系统筛查的重要性，尤其是在该人群中。
