tPA Outcomes in Patients 80 Years of Age Or Older Following Acute Ischemic Stroke
AAPA ePoster library. Andreeff R. 05/17/17; 180485; 57
Renee Andreeff
Renee Andreeff
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Abstract
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Purpose: Stroke is one of the leading causes of death in the United States and this study sought to determine whether giving Tissue Plasminogen Activator (tPA) to patients aged 80-90 was beneficial or detrimental to their overall quality of life post stroke. Methods: IRB approval was granted. A retrospective chart review (N = 94) of patients aged 80-90 who received intravenous tPA for acute ischemic stroke between January 1, 2012, to December 31, 2015 at a single neurology office were included. Demographic data along with baseline and postoperative National Institute of Health Stroke Scaled score (NIHSS) were collected. The outcome disability was evaluated using the modified Rankin scale. Data was analyzed using Microsoft excel. Results: The majority of participants were female (77%, n = 72) with a mean age of 87 years. The majority of participants (n = 74) showed an improvement in NIHSS score by one to eight points, whereas six patients showed a significant improvement by as much as 12 points. T-test showed a statistically significant difference (p = .004) NIHSS score, pre-post tPA administration. Analysis of mRankin score revealed that the majority of patients (n = 72) had a score between 0 and 3. Of the 94 patients analyzed, 14 % (n = 13) had significant improvement and had no residual symptoms at all (score of 0); 26% (n = 24) patients had no significant disability despite symptoms and were able to carry out usual activities (score of 1), 20% (n = 19) had slight disability but were able to look after own affairs without assistance(score of 2), 17% (n = 16) had moderate disability requiring some help (score of 3), 20% (n = 19) had moderately severe disability needing assistance and unable to attend to their own body needs without assistance (score of 4) and 3% (n = 3) had severe disability and were bedridden (score of 5). Conclusion: Based on the data analysis of pre-tPA and post-tPA NIHSS and mRankin scores, patients aged 80-90 were shown to likely recover functional activity post stroke. Identifying that the use of tPA in this patient population improves outcomes is important because it shows that the benefits of using tPA inthis age group may outweigh the risks. Additional research is warranted which may lead to an expansion of treatment protocols....
Purpose: Stroke is one of the leading causes of death in the United States and this study sought to determine whether giving Tissue Plasminogen Activator (tPA) to patients aged 80-90 was beneficial or detrimental to their overall quality of life post stroke. Methods: IRB approval was granted. A retrospective chart review (N = 94) of patients aged 80-90 who received intravenous tPA for acute ischemic stroke between January 1, 2012, to December 31, 2015 at a single neurology office were included. Demographic data along with baseline and postoperative National Institute of Health Stroke Scaled score (NIHSS) were collected. The outcome disability was evaluated using the modified Rankin scale. Data was analyzed using Microsoft excel. Results: The majority of participants were female (77%, n = 72) with a mean age of 87 years. The majority of participants (n = 74) showed an improvement in NIHSS score by one to eight points, whereas six patients showed a significant improvement by as much as 12 points. T-test showed a statistically significant difference (p = .004) NIHSS score, pre-post tPA administration. Analysis of mRankin score revealed that the majority of patients (n = 72) had a score between 0 and 3. Of the 94 patients analyzed, 14 % (n = 13) had significant improvement and had no residual symptoms at all (score of 0); 26% (n = 24) patients had no significant disability despite symptoms and were able to carry out usual activities (score of 1), 20% (n = 19) had slight disability but were able to look after own affairs without assistance(score of 2), 17% (n = 16) had moderate disability requiring some help (score of 3), 20% (n = 19) had moderately severe disability needing assistance and unable to attend to their own body needs without assistance (score of 4) and 3% (n = 3) had severe disability and were bedridden (score of 5). Conclusion: Based on the data analysis of pre-tPA and post-tPA NIHSS and mRankin scores, patients aged 80-90 were shown to likely recover functional activity post stroke. Identifying that the use of tPA in this patient population improves outcomes is important because it shows that the benefits of using tPA inthis age group may outweigh the risks. Additional research is warranted which may lead to an expansion of treatment protocols....
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