Evidence map›Paper›PMID 26437998›Full record

ArticleJournal of stroke2015

Intravenous Tissue Plasminogen Activator Improves the Outcome in Very Elderly Korean Patients with Acute Ischemic Stroke.

Jay Chol Choi, Ji Sung Lee, Tai Hwan Park, Sang-Soon Park, Yong-Jin Cho, Jong-Moo Park, Kyusik Kang, Kyung Bok Lee, Soo-Joo Lee, Youngchai Ko and 21 more

Open access · diamondAbstract read
In one paragraph

Article in Journal of stroke, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors at 17 institutions in 1 country.

Jay Chol ChoiDepartment of Neurology, Jeju National University, Jeju, Korea.
Ji Sung LeeClinical Research Center, Asan Medical Center, Seoul, Korea.
Tai Hwan ParkDepartment of Neurology, Seoul Medical Center, Seoul, Korea.
Sang-Soon ParkDepartment of Neurology, Seoul Medical Center, Seoul, Korea.
Yong-Jin ChoDepartment of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Korea.
Jong-Moo ParkDepartment of Neurology, Eulji General Hospital, Eulji University, Seoul, Korea.
Kyusik KangDepartment of Neurology, Eulji General Hospital, Eulji University, Seoul, Korea.
Kyung Bok LeeDepartment of Neurology, Soonchunhyang University College of Medicine, Seoul, Korea.
Soo-Joo LeeDepartment of Neurology, Eulji University Hospital, Daejeon, Korea.
Youngchai KoDepartment of Neurology, Eulji University Hospital, Daejeon, Korea.
Jae Guk KimDepartment of Neurology, Eulji University Hospital, Daejeon, Korea.
Jun LeeDepartment of Neurology, Yeungnam University Hospital, Daegu, Korea.
Ki-Hyun ChoDepartment of Neurology, Chonnam National University Hospital, Gwangju, Korea.
Joon-Tae KimDepartment of Neurology, Chonnam National University Hospital, Gwangju, Korea.
Kyung-Ho YuDepartment of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Byung-Chul LeeDepartment of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Mi-Sun OhDepartment of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Jae-Kwan ChaDepartment of Neurology, Dong-A University College of Medicine, Busan, Korea.
Dae-Hyun KimDepartment of Neurology, Dong-A University College of Medicine, Busan, Korea.
Hyun-Wook NahDepartment of Neurology, Dong-A University College of Medicine, Busan, Korea.
Dong-Eog KimDepartment of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.
Wi-Sun RyuDepartment of Neurology, Dongguk University Ilsan Hospital, Goyang, Korea.
Beom Joon KimDepartment of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Hee-Joon BaeDepartment of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
Wook-Joo KimDepartment of Neurology, Ulsan University Hospital, Ulsan, Korea.
Dong-Ick ShinDepartment of Neurology, Chungbuk National University Hospital, Cheongju, Korea.
Min-Ju YeoDepartment of Neurology, Chungbuk National University Hospital, Cheongju, Korea.
Sung Il SohnDepartment of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Jeong-Ho HongDepartment of Neurology, Keimyung University Dongsan Medical Center, Daegu, Korea.
Juneyoung LeeDepartment of Biostatistics, Korea University College of Medicine, Seoul, Korea.
Keun-Sik HongDepartment of Neurology, Ilsan Paik Hospital, Inje University, Goyang, Korea.
Daejeon Eulji Medical Center, Eulji University · KRDong-A University · KRHallym University Sacred Heart Hospital · KRChonnam National University Hospital · KRChungbuk National University · KRDongguk University Ilsan Hospital · KREulji University · KRInje University Ilsan Paik Hospital · KRKorea University · KRSeoul Medical Center · KRSeoul National University Bundang Hospital · KRJeju National University · KRKeimyung University · KRKeimyung University Dongsan Medical Center · KRSoonchunhyang University · KRUlsan University Hospital · KRYeungnam University Medical Center · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeIn a recent pooled analysis of randomized clinical trials (RCTs), intravenous tissue plasminogen activator (TPA) improves the outcome in patients aged ≥80 years. However, it is uncertain whether the findings are applicable to clinical practice in Asian populations.

methodsFrom a multicenter stroke registry database of Korea, we identified patients with acute ischemic stroke who were aged ≥ 80 years. Using multivariable analysis and propensity score (PS)-matched analyses, we assessed the effectiveness and safety of intravenous TPA within 4.5 hours.

resultsAmong 2,334 patients who met the eligible criteria, 236 were treated with intravenous TPA (mean age, 83±5; median NIHSS, 13 [IQR, 8-17]). At discharge, the TPA group compared to the no-TPA group had a favorable shift on the modified Rankin Scale (mRS) score (multivariable analysis, OR [95% CI], 1.51 [1.17-1.96], P=0.002; PS-matched analysis, 1.54 [1.17-2.04], P=0.002) and was more likely to achieve mRS 0-1 outcome (multivariable analysis, 2.00 [1.32-3.03], P=0.001; PS-matched analysis, 1.59 [1.04-2.42], P=0.032). TPA treatment was associated with an increased risk of symptomatic intracranial hemorrhage (multivariable analysis, 5.45 [2.80-10.59], P<0.001; PS-matched analysis, 4.52 [2.24-9.13], P<0.001), but did not increase the in-hospital mortality (multivariable analysis, 0.86 [0.50-1.48], P=0.58; PS-matched analysis, 0.88 [0.52-1.47], P=0.61).

conclusionsIn the setting of clinical practice, intravenous TPA within 4.5 hours improved the functional outcome despite an increased risk of symptomatic intracranial hemorrhage in very elderly Korean patients. The findings, consistent with those from pooled analysis of RCTs, strongly support the use of TPA for this population.

Indexed as

ElderlyIschemic strokeOutcome assessmentThrombolytic therapy

Identifiers

PMID26437998
PMCPMC4635722
OpenAlexW1788557698

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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.