Comparison of the Outcome of Altplas Administration after Acute Ischemic Stroke in Patients Over 80 Years and Under 80 Years Admitted

Abstract

Introduction: Due to the presence of risk factors leading to bleeding in old age on one hand and the significant effect of alteplase in improving the symptoms of ischemic stroke on the other hand, also considering the high cost of rtPA injection, there are controversies regarding administration of rtPA in patients over 80 years of age. Therefore, in this study, we will compare the results of alteplase administration in patients over 80 years old and under 80 years old after AIS hospitalized in Allameh Bohlool Hospital, Gonabad, Iran.
Material & Method: The present study was a retrospective cross-sectional study. We collected information of all patients hospitalized due to stroke in Allameh Bahloul Gonabadi Hospital during the years 2016 to 2021. Patients treated with rtPA were divided into two groups under 80 years and over 80 years and the treatment results were compared.
Results: In the present study, the first group included 16 patients over 80 years old (86.00±4.25) and 35 patients under 80 years old (65.62±10.77). NIHSS at the time of arrival and at the time of discharge in the first group was 13.25 ± 4.41 and 3.84 ± 4.66 respectively, and in the second group it was 12.20 ± 5.44 and 4.37 ± 4.48, respectively. Based on the NIHSS score, 10 people from the first group (62.5%) and 25 people from the second group (71.42%) improved (P value = 0.534). Finally, 3 people from the first group (18.3%) and 3 people from the second group (8.6%) died.
Conclusion: The present study showed that alteplase has good therapeutic results in patients over 80 years old as well as in patients under 80 years old . Alteplase for AIS should be evaluated on an individual benefit-risk basis.