Clinical Outcomes of Reperfusion Therapies in Elderly Patients with Acute Ischemic Stroke

Abstract

Stroke remains the major cause of disability and mortality worldwide. The incidence of ischemic stroke increases with age and is particularly high in people aged ≥80 years. This study aimed to evaluate the efficacy and safety of reperfusion therapies (intravenous thrombolysis, endovascular thrombectomy, intravenous thrombolysis+ endovascular thrombectomy) in acute ischemic stroke patients aged over 80 years in one of the largest comprehensive stroke centers in Armenia. The study was based on retrospective analyses of prospectively gathered data from all stroke patients of Astghik medical center benefiting reperfusion therapies from 1 February 2021 to 30 April 2022. The safety was evaluated by assessing in-hospital complications and in-hospital and 3-months mortality rates. The efficacy was defined as neurological improvement at discharge and a modified Rankin scale 0-2 (or a return to at least the pre-stroke modified Rankin scale) at 3 months. A total of 216 patients with acute ischemic stroke were treated with reperfusion therapies. The number of patients aged 80 years or over was 41(18,9%). The study group had a mortality rate of 9,7% in an in-hospital setting and 22% at 3 months. Symptomatic intracranial hemorrhage was detected in 3 cases (7.3%). None of the patients developed aspiration pneumonia. 32 patients (78%) had neurological improvement at discharge and 21 patients (51%) were independent or regained pre-stroke activities at 3 months. Based on our results we support the wider application of reperfusion therapies in this age group to reduce disability and improve post-stroke outcomes.