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KMID : 1005420150170030173
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Journal of Cerebrovascular and Endovascular Neurosurgery
2015 Volume.17 No. 3 p.173 ~ p.179
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Endovascular Treatment for Acute Ischemic Stroke Patients over 80 Years of Age
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Hwang Ki-Hwan
Hwang Gyo-Jun
Kwon O-Ki
Kim Chang-Hyeun
Ban Seung-Pil
Han Moon-Ku
Bae Hee-Joon
Kim Beom-Joon
Bang Jae-Seung
Oh Chang-Wan
Lee Bo-ram
Jeong Eun-A
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Abstract
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Objective:We evaluated the effect of endovascular treatment (EVT) for acute ischemic stroke in patients over 80 years of age.
Materials and Methods:The records of 156 acute stroke patients aged over 80 years who were considered as candidates for EVT were analyzed. Fifty-six patients (35.9%, EVT group) underwent EVT and 100 patients (64.1%, non-EVT group) did not. Outcomes, in terms of functional outcomes and rates of symptomatic hemorrhage, in-hospital morbidity and mortality, were compared between groups. Each comparison was adjusted for age, time from onset, initial National Institute of Health Stroke Scale, and pre-stroke modified Rankin Scale (mRS).
Results:More patients in the EVT group achieved good outcomes (mRS score of 0-2) at 3 months (35.7% vs. 11.0%, adjusted odds ratio [OR] 4.779 [95% confidence interval 1.972-11.579], p = 0.001) and 12 months (35.7% vs. 14.0%, adjusted OR 3.705 [1.574-8.722], p = 0.003) after stroke. During admission, rates of hospital-acquired infection including pneumonia (12.5% vs. 29.0%, adjusted OR 0.262 [0.098-0.703], p = 0.008) and urinary tract infection (16.0% vs. 34.0%, adjusted OR 0.256 [0.099-0.657], p = 0.005) were significantly lower in the EVT group. More symptomatic hemorrhages (10.7% vs. 2.0%, adjusted OR 6.859 [1.139-41.317], p = 0.036) occurred in the EVT group, but no significant difference was observed in in-hospital mortality rate (12.5% vs. 8.0%, adjusted OR 1.380 [0.408-4.664], p = 0.604).
Conclusion:EVT improved functional outcome and reduced the risk of hospital-acquired infections in acute stroke patients over 80 years of age without increasing the risk of in-hospital mortality, although symptomatic hemorrhage occurred more frequently after EVT.
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KEYWORD
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Stroke, Aged, Thrombolytic therapy
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