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90 years of age or older acute ischemic stroke can still thrombolysis


With the aging of the accelerated, ultra-elderly patients in the proportion of stroke patients will become increasingly large.According to the guidelines for diagnosis and treatment of acute ischemic stroke in China in 2014, patients with acute ischemic stroke can receive intravenous tPA thrombolysis within 3 to 4.5 hours, and age is not an absolute contraindication for thrombolysis. But in clinical practice, older patients are sometimes excluded.

American and Canadian scholar-related studies have shown that with age, patient mortality has increased, but the rise in mortality is not because these patients are more prone to symptomatic hemorrhagic stroke. (Stroke. 2016, 47: 2347)

The researchers analyzed the data of the "follow the guide walk" - the stroke national quality improvement registry, incorporating patient data from 2009 to 2013.

The results showed that 2585 patients (7.2%) were ≥ 90 years of age in patients who received tPA thrombolysis within 2 hours of all symptoms episodes. Compared with younger (18-89) patients, patients with ≥90 years of age with tPA thrombolysis had lower contraindications (67.4% and 84.1%). The prognosis of patients at 90 years of age: 31.4% of patients discharged from hospital or acute phase; 13.4% of patients walking at discharge; 6.1% of patients with symptomatic hemorrhagic stroke; death or discharge to hospital The proportion of patients in the hospital was 36.4%. In patients with symptomatic hemorrhagic stroke, patients with age ≥90 years were at higher risk of bleeding than those younger than 65 years of age, but no significant difference compared with 66 to 89 years of age.

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