Older age is not related to hemorrhagic transformation and favorable outcomes in patients with wake-up ischemic stroke undergoing intravenous thrombolytic therapy.
- Author:
Li-ping ZHAI
1
;
Zhi-cai CHEN
2
;
Shen-qiang YAN
2
;
Gen-long ZHONG
2
;
Sheng ZHANG
2
;
Meng-jun XU
2
;
Min LOU
2
Author Information
- Publication Type:Journal Article
- MeSH: Administration, Intravenous; Age Factors; Aged; Aged, 80 and over; Brain Ischemia; diagnosis; drug therapy; Female; Fibrinolytic Agents; administration & dosage; therapeutic use; Humans; Male; Recombinant Proteins; administration & dosage; therapeutic use; Retrospective Studies; Risk Factors; Stroke; diagnosis; drug therapy; Thrombolytic Therapy; Tissue Plasminogen Activator; administration & dosage; therapeutic use; Treatment Outcome
- From: Journal of Zhejiang University. Medical sciences 2015;44(6):638-644
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate factors related to hemorrhagic transformation and favorable outcomes in wake-up ischemic stroke (WUIS) patients undergoing intravenous thrombolytic therapy.
METHODSClinical data of 600 patients undergoing multimodal image-guided intravenous recombinant tissue plasminogen activator (rt-PA) therapy in Department of Neurology, the Second Affiliated Hospital, Zhejiang University School of Medicine center from May 2009 to May 2015 were retrospectively analyzed. Among 600 patients, 68 were diagnosed as WUIS including 17 cases aged 80 or older. Hemorrhagic transformation within the first 24 h after thrombolysis was assessed according to ECASS II criteria. Favorable outcome was defined as three-month modified Rankin Scale (mRS) 0-3. Univariate and binary logistic regression were used to analyze the risk factors of hemorrhagic transformation and poor clinical outcomes in WUIS patients.
RESULTSUnivariate analysis showed that WUIS patients aged ≥ 80 years had a lower rate in males (41.2% vs 76.5%, P=0.007), smokers (11.8% vs 43.1%, P=0.019) and favorable outcome (52.9% vs 78.4%, P=0.043); and a higher rate of cardiac embolism (64.7% vs 35.3%, P=0.034) compared with those aged <80 years. Binary logistic regression showed that age was not an independent risk factor for favorable outcome (OR=0.524, 95% CI:0.141-1.953, P=0.336) or hemorrhagic transformation (OR=1.039, 95% CI: 0.972-1.111, P=0.262).
CONCLUSIONOlder age is not related to the favorable outcome or hemorrhagic transformation in WUIS patients undergoing multimodal image-guided intravenous thrombolytic therapy.
