好色先生

好色先生

Explore the latest content from across our publications
Join The AAN

Log In

Forgot Password?
Create New Account

Loading... please wait

Abstract Details

Utility of IV thrombolysis and mechanical thrombectomy in nonagenarians with acute ischemic stroke
Cerebrovascular Disease and Interventional Neurology
P14 - Poster Session 14 (11:45 AM-12:45 PM)
13-006
Analyze outcomes of IV- tPA and MT in nonagenarians and assess predictors of worse outcomes.
Stroke risk increases with age and nonagenarians comprise 17% of stroke patients. In nonagenarians, risk/benefits of thrombolysis (IV-tPA) +/- thrombectomy (MT) are less studied. We hypothesized nonagenarians would have worse outcomes and more complications.
Retrospective review of nonagenarians and <90 yo who underwent IV-tPA +/- MT at Loyola  2018-2020. We recorded age, sex, race, ethnicity, length of stay (LOS), intervention type, time to treatment, TICI scores, NIHSS (inital and discharge), mRS (premorbid and discharge), stroke risk factors and vascular territory, disposition, and hospital complications. We report descriptive data. Odds ratio estimates of mRS outcome (good =mRS 0-2) following treatment were calculated using Wald 95% confidence intervals and Chi square p-values.
185 patients underwent IV-tPA +/- MT. Twenty-five were nonagenarians and 160 were <90 yo. Nonagenarians were more likely to have worse mRS at discharge compared to <90 for IV-tPA. For IV-tPA + MT, (OR for good mRS at discharge was 42% reduced for nonagenarians compared to <90 yo), though not statistically significant. There were no significant differences in outcome between males and females. Nonagenarians had a significantly shorter LOS compared to <90 yo patients (median LOS for nonagenarians was 3.00 days (2.00–5.00), for <90 yo LOS was 6.00 days (4.00–10.00). There were no significant differences in hospital complication though there was a trend to more hemorrhagic conversion in nonagenarians (OR 1.57 (p=0.34)

Nonagenarians had worse functional outcomes, though these differences were not statistically significant. Lower LOS for nonagenarians may reflect hospice disposition or death. IV-tPA may be beneficial in nonagenarians, but the likelihood of good outcome may be lower. A larger prospective cohort registry of nonagenarian stroke patients undergoing IV-tPA +/- MT may be warranted. 

 
Authors/Disclosures
Tasha A. Tombo
PRESENTER 		Ms. Tombo has nothing to disclose.
Anam Syed, DO (Rush University Medical Center) Dr. Syed has nothing to disclose.
No disclosure on file
Michael J. Schneck, MD, FAAN (Loyola University Chicago, Stritch School of Medicine) An immediate family member of Dr. Schneck has received personal compensation for serving as an employee of Cellcarta. Dr. Schneck has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for HLT Medical. Dr. Schneck has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Miscellaneous legal firms. Dr. Schneck has stock in Baxter Labs. The institution of Dr. Schneck has received research support from NIH.