Endovascular Treatment for Acute Ischemic Stroke Patients over 80 Years of Age.
10.7461/jcen.2015.17.3.173
- Author:
Kihwan HWANG
1
;
Gyojun HWANG
;
O Ki KWON
;
Chang Hyeun KIM
;
Seung Pil BAN
;
Moon Ku HAN
;
Hee Joon BAE
;
Beom Joon KIM
;
Jae Seung BANG
;
Chang Wan OH
;
Boram LEE
;
Eun A JEONG
Author Information
1. Department of Neurosurgery, Regional Caridocerebrovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea. storynlemon@gmail.com
- Publication Type:Original Article
- Keywords:
Stroke;
Aged;
Thrombolytic therapy
- MeSH:
Hemorrhage;
Hospital Mortality;
Humans;
Mortality;
Odds Ratio;
Pneumonia;
Stroke*;
Thrombolytic Therapy;
Urinary Tract Infections
- From:Journal of Cerebrovascular and Endovascular Neurosurgery
2015;17(3):173-179
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
