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Stroke Research and Treatment
Volume 2012 (2012), Article ID 923676, 7 pages
Clinical Study

Intravenous Thrombolytic Treatment in the Oldest Old

1Stroke Center, Department of Neurology, University Hospital Ramon y Cajal, IRYCIS, Health Research Institute, University of Alcalá de Henares, 28034 Madrid, Spain
2Stroke Center, Department of Neurology, University Hospital Clínico San Carlos, The Complutense University, 28040 Madrid, Spain
3Stroke Center, Department of Neurology, Neurosciences Research, IdiPAZ, Health Research Institute, University Hospital La Paz, Autonoma University of Madrid, 28046 Madrid, Spain
4Stroke Center, Department of Neurology, Princesa Health Research Institute, University Hospital La Princesa, Autonoma University, 28006 Madrid, Spain
5Stroke Center, Department of Neurology, University Hospital Gregorio Marañon, Complutense University, 28009 Madrid, Spain

Received 27 March 2012; Revised 23 May 2012; Accepted 28 May 2012

Academic Editor: Chelsea S. Kidwell

Copyright © 2012 Juan García-Caldentey et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background and Purpose. Intravenous thrombolysis using tissue plasminogen activator is safe and probably effective in patients >80 years old. Nevertheless, its safety has not been specifically addressed for the oldest old patients (≥85 years old, OO). We assessed the safety and effectiveness of thrombolysis in this group of age. Methods. A prospective registry of patients treated with intravenous thrombolysis. Patients were divided in two groups (<85 years and the OO). Demographic data, stroke aetiology and baseline National Institute Health Stroke Scale (NIHSS) score were recorded. The primary outcome measures were the percentage of symptomatic intracranial haemorrhage (SICH) and functional outcome at 3 months (modified Rankin Scale, mRS). Results. A total of 1,505 patients were registered. 106 patients were OO [median 88, range 85–101]. Female sex, hypertension, elevated blood pressure at admission, cardioembolic strokes and higher basal NIHSS score were more frequent in the OO. SICH transformation rates were similar (3.1% versus 3.7%, 𝑃 = 1 . 0 0 ). The probability of independence at 3 months (mRS 0–2) was lower in the OO (40.2% versus 58.7%, 𝑃 = 0 . 0 0 1 ) but not after adjustment for confounding factors (adjusted OR, 0.82; 95% CI, 0.50 to 1.37; 𝑃 = 0 . 4 5 5 ). Three-month mortality was higher in the OO (28.0% versus 11.5%, 𝑃 < 0 . 0 0 1 ). Conclusion. Intravenous thrombolysis for stroke in OO patients did not increase the risk of SICH although mortality was higher in this group.