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KMID : 0858420120140010019
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Korean Journal of Stroke
2012 Volume.14 No. 1 p.19 ~ p.28
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Effectiveness and Safety of Thrombolysis in Ischemic Stroke Patients
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Kim Wook-Joo
Kwon O-Ki
Oh Chang-Wan
Jung Cheol-Kyu
Lee Ji-Sung
Lee June-Young
Park Jung-Hyun
Ko Young-Chai
Jang Myung-Suk
Yang Mi-Hwa
Han Moon-Ku
Bae Hee-Joon
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Abstract
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Thrombolysis becomes an emerging therapeutic option for acute ischemic stroke. However, few reports exist on its use in the very elderly. We investigated whether there is a difference in the effectiveness and safety of intravenous (IV) and/ or intra-arterial (IA) thrombolysis between patients aged ≥80 years and those aged <80 years. Methods: A consecutive series of patients hospitalized within 12 hours from stroke onset were selected. We evaluated the effectiveness of thrombolysis with modified Rankin scale (mRS) at 3 months, and the safety with symptomatic hemorrhagic transformation (sHT). The odds ratio (OR) of thrombolysis on the favorable mRS (0-2) was calculated using multivariable logistic regression analysis with adjustments for potential confounders. Whether the effectiveness of thrombolysis is age-dependent or not was analyzed by introducing an interaction term (thrombolysis×age group) into multivariable models. Results: Among 219 patients ≥80 years, 21% of patients received IV or IA or combined thrombolysis while 23% of 980 patients <80 years received thrombolysis (P =0.51). With respect to the favorable mRS, the adjusted ORs of thrombolysis were 1.70 (95% confi dence interval, 1.08-2.68) in all subjects, 1.61 (0.58-4.49) in those ≥80 years, and 1.71 (1.05-2.78) in those <80 years. There was no signifi cant interaction between age group and thrombolysis (P =0.91). With respect to sHT, the adjusted OR was 4.72 (1.94-11.45) in all subjects with no signifi cant interaction (P =0.86). Conclusion: This study suggests that thrombolysis may be equally safe and effective in stroke patients aged ≥80 years versus <80 years. (Korean J Stroke 2012;14:19-28)
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KEYWORD
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Thrombolysis, Treatment outcome, Aged 80 and over
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