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Efficacy and Safety of Mechanical Thrombectomy in Older Adults with Acute Ischemic Stoke.

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Title: Efficacy and Safety of Mechanical Thrombectomy in Older Adults with Acute Ischemic Stoke.
Authors: Sallustio, Fabrizio, Koch, Giacomo, Motta, Caterina, Diomedi, Marina, Alemseged, Fana, D'Agostino, Vittoria C., Napolitano, Simone, Samà, Domenico, Davoli, Alessandro, Konda, Daniel, Morosetti, Daniele, Pampana, Enrico, Floris, Roberto, Gandini, Roberto
Source: Journal of the American Geriatrics Society. Aug2017, Vol. 65 Issue 8, p1816-1820. 5p. 4 Charts.
Subjects: Stroke treatment, Thrombolytic therapy, Academic medical centers, Patient safety
Geographic Terms: Italy
Abstract: Objectives To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke. Design Retrospective cohort study. Setting Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy. Participants Elderly adults treated for acute ischemic stroke (N = 219). Measurements Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, <80). Baseline and procedural characteristics, safety outcomes such as intracranial hemorrhage ( ICH) and mortality and efficacy outcomes such as successful reperfusion and 3-month good clinical outcome of the two groups were compared. Mutivariable analysis was performed to identify predictors of clinical outcome. Results Intravenous thrombolysis was more frequent (67.7% vs 52.8%, P = .04), and onset to reperfusion time was shorter (318.7 ± 128.7 vs 282 ± 53.5, P = .02) in participants aged 80 and older, but no between-group differences were found in terms of successful reperfusion (69% vs 63%, P = .4), good clinical outcome (30.6% vs 34.3%, P = .6), any (37% vs 37.5%, P > .99) or symptomatic (11% vs 14%, P = .6) ICH, or mortality (40.3% vs 29.2%, P = .14). Multivariable analysis revealed that, in the older group, onset National Institute of Health Stroke Scale ( NIHSS) score (odds ratio ( OR) = 0.65, 95% confidence interval ( CI) = 0.44-0.96, P = .03) and 24-hour clinical improvement ( OR = 141.13, 95% CI = 2.96-6,720.7, P = .01) were independent predictors of 3-month functional independence. Conclusion These findings suggest that endovascular treatment for stroke in selected elderly adults could be safe and effective. Major determinants of outcome in this subgroup of elderly patients are presentation NIHSS score and 24-hour clinical improvement. [ABSTRACT FROM AUTHOR]
Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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PubType: Academic Journal
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  Data: Efficacy and Safety of Mechanical Thrombectomy in Older Adults with Acute Ischemic Stoke.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke+treatment%22&quot;&gt;Stroke treatment&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Thrombolytic+therapy%22&quot;&gt;Thrombolytic therapy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Academic+medical+centers%22&quot;&gt;Academic medical centers&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Patient+safety%22&quot;&gt;Patient safety&lt;/searchLink&gt;
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– Name: Abstract
  Label: Abstract
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  Data: Objectives To evaluate the safety and efficacy of endovascular therapy in elderly adults treated for acute ischemic stroke. Design Retrospective cohort study. Setting Comprehensive Stroke Center, University of Tor Vergata, Rome, Italy. Participants Elderly adults treated for acute ischemic stroke (N = 219). Measurements Participants were divided into two groups based on their age (n = 62, ≥80; n = 157, &lt;80). Baseline and procedural characteristics, safety outcomes such as intracranial hemorrhage ( ICH) and mortality and efficacy outcomes such as successful reperfusion and 3-month good clinical outcome of the two groups were compared. Mutivariable analysis was performed to identify predictors of clinical outcome. Results Intravenous thrombolysis was more frequent (67.7% vs 52.8%, P = .04), and onset to reperfusion time was shorter (318.7 &#177; 128.7 vs 282 &#177; 53.5, P = .02) in participants aged 80 and older, but no between-group differences were found in terms of successful reperfusion (69% vs 63%, P = .4), good clinical outcome (30.6% vs 34.3%, P = .6), any (37% vs 37.5%, P &gt; .99) or symptomatic (11% vs 14%, P = .6) ICH, or mortality (40.3% vs 29.2%, P = .14). Multivariable analysis revealed that, in the older group, onset National Institute of Health Stroke Scale ( NIHSS) score (odds ratio ( OR) = 0.65, 95% confidence interval ( CI) = 0.44-0.96, P = .03) and 24-hour clinical improvement ( OR = 141.13, 95% CI = 2.96-6,720.7, P = .01) were independent predictors of 3-month functional independence. Conclusion These findings suggest that endovascular treatment for stroke in selected elderly adults could be safe and effective. Major determinants of outcome in this subgroup of elderly patients are presentation NIHSS score and 24-hour clinical improvement. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Journal of the American Geriatrics Society is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=124623535
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        Value: 10.1111/jgs.14909
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        Text: English
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    Subjects:
      – SubjectFull: Stroke treatment
        Type: general
      – SubjectFull: Thrombolytic therapy
        Type: general
      – SubjectFull: Academic medical centers
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      – SubjectFull: Patient safety
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      – SubjectFull: Italy
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      – TitleFull: Efficacy and Safety of Mechanical Thrombectomy in Older Adults with Acute Ischemic Stoke.
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              Text: Aug2017
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