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Efficacy and safety of reperfusion treatments in middle-old and oldest-old stroke patients.

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Title: Efficacy and safety of reperfusion treatments in middle-old and oldest-old stroke patients.
Authors: Viticchi, Giovanna (AUTHOR), Potente, Eleonora (AUTHOR), Falsetti, Lorenzo (AUTHOR), Burattini, Marco (AUTHOR), Bartolini, Marco (AUTHOR), Buratti, Laura (AUTHOR), Pelliccioni, Giuseppe (AUTHOR), Silvestrini, Mauro (AUTHOR)
Source: Neurological Sciences. Jul2022, Vol. 43 Issue 7, p4323-4333. 11p. 3 Charts, 2 Graphs.
Subjects: Stroke patients, Older patients, Stroke units, Ischemic stroke, Reperfusion, Stroke, Retrospective studies, Treatment effectiveness, Thrombectomy, Cerebral ischemia, Disease complications
Abstract: Introduction: Intravenous thrombolysis (IT) and mechanical thrombectomy (MT) have significantly changed the clinical outcome of acute ischaemic stroke (AIS). Concerns about possible complications often reduce the use of these treatment options for older patients, preferentially managed with antiplatelet therapy (AT). Aim of this study was to evaluate, in a population of middle-old (75-84 years) and oldest-old (≥ 85 years) subjects, the efficacy and safety of different treatments for AIS (IT, IT + MT, MT or AT), mortality and incidence of serious complications.Patients and Methods: All patients aged over 75 years admitted for AIS in two Stroke Units were enrolled. The physician in each case considered all treatment options and chose the best approach. NIHSS and modified Rankin Scale (mRS) were obtained and differences between admission and discharge scores, defined as delta(NIHSS) and delta(mRS), were calculated. The relationship between delta(NIHSS), delta(mRS) and type of procedure was analysed with a GLM/Multivariate model. Differences in mortality and incidence of serious complications were analysed with the chi-square test.Results: A total of 273 patients, mean age 84.07 (± 5.47) years, were included. The Delta(NIHSS) was significantly lower in patients treated with AT than in those treated with IT and MT (p < 0.009 and p < 0.005, respectively). Haemorrhagic infarction occurrence was significantly lower (p < 0.0001) among patients treated with AT (10.6%) or IT (16.7%) compared to MT (34.9%) or MT + IT (37.0%). No significant difference was observed for in-hospital mortality. Age did not influence the outcome.Conclusions: Our results suggest that IT and AT are effective and relatively safe approaches in middle-aged and older patients. [ABSTRACT FROM AUTHOR]
Copyright of Neurological Sciences is the property of Springer Nature 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.)
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  Data: Efficacy and safety of reperfusion treatments in middle-old and oldest-old stroke patients.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Viticchi%2C+Giovanna%22&quot;&gt;Viticchi, Giovanna&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Potente%2C+Eleonora%22&quot;&gt;Potente, Eleonora&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Falsetti%2C+Lorenzo%22&quot;&gt;Falsetti, Lorenzo&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Burattini%2C+Marco%22&quot;&gt;Burattini, Marco&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bartolini%2C+Marco%22&quot;&gt;Bartolini, Marco&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Buratti%2C+Laura%22&quot;&gt;Buratti, Laura&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Pelliccioni%2C+Giuseppe%22&quot;&gt;Pelliccioni, Giuseppe&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Silvestrini%2C+Mauro%22&quot;&gt;Silvestrini, Mauro&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Neurological+Sciences%22&quot;&gt;Neurological Sciences&lt;/searchLink&gt;. Jul2022, Vol. 43 Issue 7, p4323-4333. 11p. 3 Charts, 2 Graphs.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke+patients%22&quot;&gt;Stroke patients&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Older+patients%22&quot;&gt;Older patients&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke+units%22&quot;&gt;Stroke units&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Ischemic+stroke%22&quot;&gt;Ischemic stroke&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Reperfusion%22&quot;&gt;Reperfusion&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke%22&quot;&gt;Stroke&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Retrospective+studies%22&quot;&gt;Retrospective studies&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Treatment+effectiveness%22&quot;&gt;Treatment effectiveness&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Thrombectomy%22&quot;&gt;Thrombectomy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Cerebral+ischemia%22&quot;&gt;Cerebral ischemia&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Disease+complications%22&quot;&gt;Disease complications&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: &lt;bold&gt;Introduction: &lt;/bold&gt;Intravenous thrombolysis (IT) and mechanical thrombectomy (MT) have significantly changed the clinical outcome of acute ischaemic stroke (AIS). Concerns about possible complications often reduce the use of these treatment options for older patients, preferentially managed with antiplatelet therapy (AT). Aim of this study was to evaluate, in a population of middle-old (75-84&#160;years) and oldest-old (≥ 85&#160;years) subjects, the efficacy and safety of different treatments for AIS (IT, IT + MT, MT or AT), mortality and incidence of serious complications.&lt;bold&gt;Patients and Methods: &lt;/bold&gt;All patients aged over 75&#160;years admitted for AIS in two Stroke Units were enrolled. The physician in each case considered all treatment options and chose the best approach. NIHSS and modified Rankin Scale (mRS) were obtained and differences between admission and discharge scores, defined as delta(NIHSS) and delta(mRS), were calculated. The relationship between delta(NIHSS), delta(mRS) and type of procedure was analysed with a GLM/Multivariate model. Differences in mortality and incidence of serious complications were analysed with the chi-square test.&lt;bold&gt;Results: &lt;/bold&gt;A total of 273 patients, mean age 84.07 (&#177; 5.47) years, were included. The Delta(NIHSS) was significantly lower in patients treated with AT than in those treated with IT and MT (p &lt; 0.009 and p &lt; 0.005, respectively). Haemorrhagic infarction occurrence was significantly lower (p &lt; 0.0001) among patients treated with AT (10.6%) or IT (16.7%) compared to MT (34.9%) or MT + IT (37.0%). No significant difference was observed for in-hospital mortality. Age did not influence the outcome.&lt;bold&gt;Conclusions: &lt;/bold&gt;Our results suggest that IT and AT are effective and relatively safe approaches in middle-aged and older patients. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Neurological Sciences is the property of Springer Nature 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.)
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        Value: 10.1007/s10072-022-05958-4
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        Text: English
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    Subjects:
      – SubjectFull: Stroke patients
        Type: general
      – SubjectFull: Older patients
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      – SubjectFull: Stroke units
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      – SubjectFull: Ischemic stroke
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      – SubjectFull: Reperfusion
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      – SubjectFull: Thrombectomy
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      – SubjectFull: Cerebral ischemia
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      – SubjectFull: Disease complications
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              Text: Jul2022
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