Department of Neurology, Hospital Universitario Ramón y Cajal, Ctra de Colmenar Km 9, 100, 28034, Madrid, Spain.
Department of Medicine, Universidad de Alcalá, IRYCIS, Madrid, Spain.
Eur Geriatr Med. 2021 Aug;12(4):893-897. doi: 10.1007/s41999-021-00494-4. Epub 2021 Apr 28.
The benefit of intravenous alteplase is well established for patients with disabling stroke symptoms regardless of age, although data on outcomes in centenarian patients are scarce. We present our experience in patients beyond 100 years.
Descriptive study including centenarians from our single-centre prospective registry who underwent intravenous thrombolysis with alteplase for acute ischemic stroke in our tertiary university hospital. Clinical variables and functional outcome at 3 months were collected.
Four patients, all women, functionally independent (mRS ≤ 2) were included. Treatment with alteplase was applied within 4.5 h of stroke onset. One patient complicated with pneumonia and died. Two patients were functionally independent (mRS ≤ 2) at discharge, while the third was partially dependent (mRS of 3 at discharge), improving after 3 months, (mRS 2). No serious hemorrhagic or systemic adverse events were registered.
In our experience, intravenous thrombolysis may be beneficial and should be considered in patients over 100 years old with no previous disability.
静脉注射阿替普酶对有残疾症状的卒中患者有益，这一结论已经得到证实，无论患者年龄大小，尽管百岁以上患者的结局数据有限。我们在此报告我们在 100 岁以上患者中的经验。
这是一项描述性研究，纳入了我们单中心前瞻性登记处的百岁以上患者，这些患者在我们的三级大学医院因急性缺血性卒中接受了阿替普酶静脉溶栓治疗。收集了临床变量和 3 个月时的功能结局。
4 名患者均为女性，且功能独立（mRS≤2）。阿替普酶治疗在卒中发作后 4.5 小时内应用。1 例患者并发肺炎并死亡。2 例患者出院时功能独立（mRS≤2），第 3 例患者出院时部分依赖（mRS 3），3 个月后（mRS 2）改善。未记录到严重出血或全身不良事件。
根据我们的经验，对于无先前残疾的 100 岁以上患者，静脉溶栓可能是有益的，应考虑使用。
