Evidence map›Paper›PMID 26492944›Full record

Observational studyEuropean journal of neurology2016

Intravenous thrombolysis for acute ischaemic stroke in the elderly: data from the Baden-Wuerttemberg stroke registry.

B Reuter, C Gumbinger, T Sauer, H Wiethölter, I Bruder, S Rode, P A Ringleb, R Kern, W Hacke, M G Hennerici and 1 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in European journal of neurology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 14% 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

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Management of acute ischemic stroke, thrombolysis rate, and predictors of clinical outcome.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2019
    Article
  8. Article
  9. Article
  10. Article
  11. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

B ReuterDepartment of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
C GumbingerDepartment of Neurology, University of Heidelberg, Heidelberg, Germany.
T SauerDepartment of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
H Wiethölter(formerly) Department of Neurology, Bürgerhospital, Stuttgart, Germany.
I BruderOffice for Quality Assurance in Hospitals (GeQiK), Baden-Wuerttembergische Hospital Association, Stuttgart, Germany.
S RodeOffice for Quality Assurance in Hospitals (GeQiK), Baden-Wuerttembergische Hospital Association, Stuttgart, Germany.
P A RinglebDepartment of Neurology, University of Heidelberg, Heidelberg, Germany.
R KernDepartment of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
W HackeDepartment of Neurology, University of Heidelberg, Heidelberg, Germany.
M G HennericiDepartment of Neurology, Universitätsmedizin Mannheim, University of Heidelberg, Mannheim, Germany.
Stroke Working Group of Baden-Wuerttemberg
Heidelberg University · DEBaden-Wuerttemberg Cooperative State University · DEBürgerhospital Frankfurt am Main · DEUniversity Hospital Heidelberg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeIn Europe intravenous thrombolysis (IVT) for ischaemic stroke is still not approved for patients aged >80 years. However, elderly patients are frequently treated based on individual decision making. In a retrospective observational study a consecutive and prospective stroke registry in southwest Germany was analysed.

methodsThe data registry collected 101,349 patients with ischaemic stroke hospitalized from January 2008 to December 2012. Of these, 38,575 (38%) were aged 80 years and older and 10 286 (10.1%) underwent IVT. Favourable outcome at discharge was defined as modified Rankin Scale (mRS) ≤1 or not worse than prior to stroke. Multiple logistic regression models stratified by 10-year age groups were used to assess the relationship between IVT and mRS at discharge, adjusted for patient characteristics, admitting facility and length of hospital stay.

resultsThe highest IVT rate was 15% in patients aged <50 years, with a continuous decline down to 8% in patients aged ≥90 years. Adjusted odds ratios and 95% confidence intervals for patients 80-89 years of age were 2.20 (1.95-2.47) (P < 0.0001) and 1.25 (0.88-1.78) (P = 0.21) for patients >90 years of age, compared to patients of the same age decade not treated with IVT.

conclusionsThe evidence from routine hospital care in southwest Germany indicates that IVT is an effective treatment also for aged patients with ischaemic stroke in an age range between 80 and 89 years. Although no clear evidence for the effectiveness of IVT beyond 90 years was found, treatment should also be carefully considered in these patients. High age should not discourage from treatment.

Indexed as

RegistriesAdministration, IntravenousAgedAged, 80 and overBrain IschemiaFemaleGermanyHumansMaleMiddle AgedOutcome Assessment, Health CareRetrospective StudiesStrokeThrombolytic Therapyacute strokeageepidemiology of strokestroke unit conceptthrombolytic therapy

Identifiers

PMID26492944
OpenAlexW2115651959

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.