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Titel: Acute stroke treatment and outcome in the oldest old (90 years and older) at a tertiary care medical centre in Germany-a retrospective study showing safety and efficacy in this particular patient population
VerfasserIn: Kauffmann, Jil
Grün, Daniel
Yilmaz, Umut
Wagenpfeil, Gudrun
Faßbender, Klaus
Fousse, Mathias
Unger, Marcus M.
Sprache: Englisch
Titel: BMC Geriatrics
Bandnummer: 21
Heft: 1
Verlag/Plattform: BMC
Erscheinungsjahr: 2021
Freie Schlagwörter: Stroke
Geriatrics
Elderly
Thrombolysis
Thrombectomy
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Background Stroke is among the most common causes of death and disability worldwide. Despite the relevance of stroke-related disease burden, which is constantly increasing due to the demographic change in industrialized countries with an ageing population and consecutively an increase in age-associated diseases, there is sparse evidence concerning acute stroke treatment and treatment-related outcome in the elderly patient group. This retrospective study aimed at analysing patient characteristics, therapy-related complications and functional outcome in stroke patients aged 90 years or older who underwent acute stroke treatment (i.e. intravenous thrombolysis, mechanical thrombectomy, or both). Methods We identified files of all inpatient stays at the Department of Neurology at Saarland University Medical Center (tertiary care level with a comprehensive stroke unit) between June 2011 and December 2018 and filtered for subjects aged 90 years or older at the time of admission. We reviewed patient files for demographic data, symptoms upon admission, (main) diagnoses, comorbidities, and administered therapies. For patients admitted due to acute stroke we reviewed files for therapy-related complications and functional outcome. We compared the modified Rankin scale (mRS) scores upon admission and at discharge for these patients. Results We identified 566 inpatient stays of subjects aged 90 years or older. Three hundred sixty-seven of the 566 patients (64.8%) were admitted and discharged due to symptoms indicative of stroke. Two hundred eleven patients received a diagnosis of ischaemic stroke. These 211 patients were analysed subsequently. Sixty-four patients qualified for acute stroke treatment (intravenous thrombolysis n = 22, mechanical thrombectomy n = 26, intravenous thrombolysis followed by mechanical thrombectomy n = 16) and showed a significant improvement in their functional status as measured by change in mRS score (admission vs. discharge, p 0.001) with 7 (10.9%) observed potentially therapy-related complications (relevant drop in haemoglobin n = 2, subarachnoidal haemorrhage n = 1, cerebral haemorrhage n = 3, extracranial bleeding n = 1). One intravenous thrombolysis was stopped because of an uncontrollable hypertensive crisis. Patients who did not qualify for these treatments (including those declining acute treatment) did not show a change of their functional status between admission and discharge (p 0.064). Conclusion Our data indicate that acute stroke treatment is effective and safe in the oldest old. Age alone is no criterion to withhold an acute intervention even in oldest old stroke patients.
DOI der Erstveröffentlichung: 10.1186/s12877-021-02566-3
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-357759
hdl:20.500.11880/32619
http://dx.doi.org/10.22028/D291-35775
ISSN: 1471-2318
Datum des Eintrags: 17-Mär-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplementary Information
In Beziehung stehendes Objekt: https://ndownloader.figstatic.com/files/31267916
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Medizinische Biometrie, Epidemiologie und medizinische Informatik
M - Neurologie und Psychiatrie
M - Radiologie
Professur: M - Prof. Dr. Klaus Faßbender
M - Prof. Dr. Stefan Wagenpfeil
M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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