ArticleJournal of neurology, neurosurgery, and psychiatry2007
Thrombolytic therapy for acute ischaemic stroke in octogenarians: selection by magnetic resonance imaging improves safety but does not improve outcome.
Article in Journal of neurology, neurosurgery, and psychiatry, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- [European Stroke Organisation 2008 guidelines for managing acute cerebral infarction or transient ischemic attack : part 2].Der Nervenarzt · 2008Guideline
- Characteristics, temporal trends and outcomes of intravenous thrombolysis in Chinese patients aged>80 years who had a stroke.Stroke and vascular neurology · 2025Observational
- [Management of acute ischemic stroke : Bridging vs. mothership].Radiologie (Heidelberg, Germany) · 2025Review
- [Intravenous lysis treatment in acute stroke treatment-latest situation].Der Radiologe · 2019Review
- Prevention and Treatment of Acute Stroke in the Nonagenarians and Beyond: Medical and Ethical Issues.Current treatment options in neurology · 2019Review
- Re-evaluation of the stroke prognostication using age and NIH Stroke Scale index (SPAN-100 index) in IVT patients - the-SPAN 100BMC neurology · 2018Article
- Impact of leukoaraiosis on parenchymal hemorrhage in elderly patients treated with thrombolysis.Neuroradiology · 2016Article
- Absolute and Relative Contraindications to IV rt-PA for Acute Ischemic Stroke.The Neurohospitalist · 2015Review
- Article
- Safety and efficacy of thrombolysis with intravenous alteplase in older stroke patients.Drugs & aging · 2013Review
- The Addition of MRI to CT Based Stroke and TIA Evaluation Does Not Impact One year Outcomes.The open neurology journal · 2013Article
- Article
- Intravenous thrombolysis for acute cerebral ischaemia in old stroke patients ≥ 80 years of age.Journal of neurology · 2012Article
- Interventional stroke therapies in the elderly: are we helping?AJNR. American journal of neuroradiology · 2012Article
- [Ischemic stroke patients following intravenous thrombolysis. Outcome in a regional stroke center].Der Nervenarzt · 2012Article
- [Thrombolytic treatment of acute stroke].Der Internist · 2011Article
- [Difficult decisions in stroke therapy].Der Nervenarzt · 2011Review
- Thrombolysis in very elderly people: controlled comparison of SITS International Stroke Thrombolysis Registry and Virtual International Stroke Trials Archive.BMJ (Clinical research ed.) · 2010Article
- Thrombolysis, stroke-unit admission and early rehabilitation in elderly patients.Nature reviews. Neurology · 2009Review
- Thrombolysis therapy in octogenarians.Journal of neurology, neurosurgery, and psychiatry · 2007Article
Corrections and comments
- Commented on by
Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOwing to the fear of an increased bleeding risk, thrombolytic therapy is withheld from many patients with acute stroke > 80 years of age.
objectiveTo analyse the risk for symptomatic intracranial haemorrhage (sICH), morbidity and mortality after thrombolytic therapy in octogenarians focusing, in particular, on whether patients selected using magnetic resonance imaging (MRI) had a better risk:benefit ratio.
methodsThe prospectively collected single-centre data of all patients treated with systemic thrombolytic therapy for acute ischaemic stroke since 1998 (n = 468) were reviewed, and patients > or = 80 years (n = 90) were compared with those aged < 80 years (n = 378). In addition, the group of octogenarians was analysed with respect to initial imaging modality.
resultsThe overall rate of sICH in the octogenarians was 6.9%, compared with 5.3% in younger patients (p = 0.61). In older patients selected by computed tomography, the rate of sICH was 9.4%; no patient selected by MRI had sICH (p = 0.10). Mortality in the octogenarians selected by computed tomography was 29.7% after 3 months as compared with 26.9% in the patients selected by MRI (p = 1.0). 20.3% of the octogenarians selected by computed tomography and 15.4% of those selected by MRI had a favourable outcome (modified Rankin scale < or = 1) after 3 months (p = 0.77).
conclusionCompared with younger patients, octogenarians do not have an increased risk of sICH. The use of MRI to select octogenarians for thrombolytic therapy seemed to decrease the risk of sICH, but did not influence the overall outcome after 3 months.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.