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Quality of Life After Off-Label Thrombolysis for Ischemic Stroke in Elderly Patients

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Abstract

Introduction

The use of intravenous thrombolysis with alteplase for ischemic stroke in Europe is restricted to subjects aged <80 years. Recent studies have reported the efficacy and safety of alteplase in older patients. However, data concerning the quality of life (QOL) of these elderly subjects are sparse.

Objectives

The aim of this study was to compare the QOL of patients aged ≥80 years with that of patients aged <80 years at 3 months after thrombolysis.

Method

This was a prospective study comprising French-speaking patients aged >18 years treated using thrombolytic therapy for ischemic stroke at the Hospital of Tours (Tours, France) between June 2012 and January 2013. QOL was assessed using the Stroke Impact Scale (SIS). The presence of mood disorders or cognitive impairments was also assessed.

Results

QOL was evaluated for 62 subjects among the 83 enrolled patients who received thrombolytic treatment; 21 patients were aged >80 years. Concerning scores on the SIS, using a multivariate analysis, only the memory and thinking score was significantly and negatively associated with the elderly population [odds ratio (OR) 0.036, 95 % confidence interval (CI) 0.004–0.339; p = 0.004]. No significant difference was observed among all the other QOL scores. Neurological recovery and functional status did not differ between the two groups.

Conclusion

QOL after intravenous thrombolysis in the elderly population was comparable to that of younger subjects. Despite its small sample size, this study showed promising results in favor of intravenous thrombolysis in the elderly population and highlighted the importance of systematic screening for post-stroke cognitive impairment, particularly in this population.

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Authors and Affiliations

  1. Department of Neurology, Hôpital Bretonneau, University Hospital of Tours, 2 boulevard Tonnellé, 37000, Tours, France

    Capucine Diard-Detoeuf, Séverine Debiais, Mélanie Imbert, Alexandra Musikas, Marie Gaudron & Bertrand De Toffol

  2. Laboratory of Epidemiology and Public Health, Faculty of Medicine, François Rabelais University, Tours, France

    Emeline Laurent

  3. Department of Geriatrics and Memory Center, University Hospital of Tours, Tours, France

    Caroline Hommet & Karl Mondon

  4. UMR INSERM U930, François Rabelais University, Tours, France

    Caroline Hommet & Karl Mondon

Authors
  1. Capucine Diard-Detoeuf
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  2. Séverine Debiais
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  3. Mélanie Imbert
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  4. Alexandra Musikas
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  8. Caroline Hommet
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Correspondence to Capucine Diard-Detoeuf.

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The authors declare that they received no funding for this study.

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Diard-Detoeuf, C., Debiais, S., Imbert, M. et al. Quality of Life After Off-Label Thrombolysis for Ischemic Stroke in Elderly Patients. Drugs Aging 32, 917–926 (2015). https://doi.org/10.1007/s40266-015-0307-4

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