Cerebral Thrombolysis in Rural Residents Aged ≥ 80.
Administration, Intravenous
Age Factors
Aged, 80 and over
Anticoagulants
/ administration & dosage
Cerebral Hemorrhage
/ epidemiology
Cohort Studies
Comorbidity
Female
Fibrinolytic Agents
/ administration & dosage
Humans
Male
Physical Functional Performance
Platelet Aggregation Inhibitors
/ administration & dosage
Poland
Retrospective Studies
Rural Population
/ statistics & numerical data
Stroke
/ drug therapy
Tissue Plasminogen Activator
/ administration & dosage
Treatment Outcome
Urban Population
/ statistics & numerical data
VKA
atrial fibrillation
intravenous thrombolysis
ischemic stroke
rural patients aged ≥ 80
Journal
Clinical interventions in aging
ISSN: 1178-1998
Titre abrégé: Clin Interv Aging
Pays: New Zealand
ID NLM: 101273480
Informations de publication
Date de publication:
2020
2020
Historique:
received:
30
03
2020
accepted:
05
08
2020
entrez:
16
10
2020
pubmed:
17
10
2020
medline:
4
3
2021
Statut:
epublish
Résumé
The proportion of older people in Poland is higher in rural areas than in urban areas. Thus, we aimed to evaluate treatment rate and factors associated with outcome and safety of intravenous thrombolysis (IVT) in rural residents aged ≥80 years admitted to primary stroke centers. This study was a retrospective, observational cohort study of 873 patients treated with recombinant tissue plasminogen activator (rt-PA) in primary stroke centers between February 1, 2009 and December 31, 2017. Among them were 527 rural residents and 231 (26.5%) were ≥80 years of age. The analyses between rural and urban patients aged ≥80 and between rural patients aged <80 and aged ≥80 were performed. The proportion of patients aged ≥80 treated with rt-PA was comparable in rural and urban residents (27.9% vs 24.3% We suggest that rural patients aged ≥80 may be safely treated with IVT in routine practice. However, lower efficacy and a higher mortality must be considered in former use of Vitamin K antagonist and antiplatelet or high white blood cells count.
Identifiants
pubmed: 33061326
doi: 10.2147/CIA.S256070
pii: 256070
pmc: PMC7522422
doi:
Substances chimiques
Anticoagulants
0
Fibrinolytic Agents
0
Platelet Aggregation Inhibitors
0
Tissue Plasminogen Activator
EC 3.4.21.68
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1737-1751Informations de copyright
© 2020 Sobolewski et al.
Déclaration de conflit d'intérêts
P. Sobolewski has had lectureship fees covered by Boehringer-Ingelheim, Everpharma, Allergan and travel expenses to scientific conferences covered by Boehringer-Ingelheim, Ipsen and Ever Pharma. W. Brola reports personal fees from Bayer, Sanofi Genzyme, and Novartis, and grants from Biogen, Merck, and Roche, during the conduct of the study. He has received speaker fees from and/or served on Advisory Boards for Bayer, Biogen, Sanofi Genzyme, Merck, Novartis and Roche. He also received support for congress participation, travel and accommodation grants from Biogen, Merck, Roche and Sanofi Genzyme. G. Kozera’s research activities have been funded by the Ministry of Science and High Education, Poland, Office of the Governor of Pomerania, Poland; he has received speaker’s honoraria from the Boehringer-Ingelheim, Everpharma, Bayer and Phizer. J. Wilczyski, W. Szczuchniak, T. Wójcik, A. Wach-Klink and M. Kos declare that they have no conflicts of interest in this work.
Références
Thromb Haemost. 2019 Jan;119(1):66-76
pubmed: 30597501
J Rural Health. 2015 Summer;31(3):326-33
pubmed: 25953431
Stroke. 2010 Feb;41(2):288-94
pubmed: 20056933
Stroke. 1994 Nov;25(11):2220-6
pubmed: 7974549
BMC Cardiovasc Disord. 2013 Sep 11;13:71
pubmed: 24024556
J Neurol Neurosurg Psychiatry. 1999 Nov;67(5):651-3
pubmed: 10519873
Heart. 2011 May;97(10):787-96
pubmed: 21478383
Circulation. 2007 May 22;115(20):e478-534
pubmed: 17515473
BMC Public Health. 2014 Aug 09;14:825
pubmed: 25106746
N Engl J Med. 2008 Sep 25;359(13):1317-29
pubmed: 18815396
WMJ. 2008 Jul;107(4):176-80
pubmed: 18702433
Clin Neurol Neurosurg. 2008 May;110(5):451-4
pubmed: 18353532
Eur J Neurol. 2018 May;25(5):747-e52
pubmed: 29360254
Lancet Neurol. 2013 Feb;12(2):139-48
pubmed: 23260188
BMJ. 1992 Dec 12;305(6867):1460-5
pubmed: 1493391
J Neurosci Rural Pract. 2017 Jan-Mar;8(1):49-54
pubmed: 28149081
Curr Neurovasc Res. 2018;15(1):10-17
pubmed: 29577860
Int J Stroke. 2019 Oct 26;:1747493019884525
pubmed: 31657284
Neurology. 2007 Jan 23;68(4):292-4
pubmed: 17242335
Lancet. 2014 Nov 29;384(9958):1929-35
pubmed: 25106063
Cerebrovasc Dis. 2008;25(5):457-507
pubmed: 18477843
J Rural Health. 2012 Fall;28(4):339-47
pubmed: 23083080
Circ Cardiovasc Qual Outcomes. 2019 Feb;12(2):e004973
pubmed: 30760007
Ann Agric Environ Med. 2016 Jul 15;23(3):476-81
pubmed: 27660872
Arch Neurol. 2008 May;65(5):607-11
pubmed: 18332238
Nat Clin Pract Neurol. 2008 Sep;4(9):474-5
pubmed: 18665145
Stroke. 1988 Dec;19(12):1497-500
pubmed: 3201508
Cochrane Database Syst Rev. 2014 Jul 29;(7):CD000213
pubmed: 25072528
Implement Sci. 2016 Apr 08;11:51
pubmed: 27059183
Stroke. 2008 Jun;39(6):1920-8
pubmed: 18420955
Lancet. 2012 Jun 23;379(9834):2352-63
pubmed: 22632908
J Hum Hypertens. 2014 Jan;28(1):25-31
pubmed: 23739160
Stroke. 2016 Feb;47(2):581-641
pubmed: 26696642
J Thromb Thrombolysis. 2020 Jul;50(1):174-180
pubmed: 31745858
Stroke. 2004 Jul;35(7):1763-8
pubmed: 15166386
Heart Lung Circ. 2017 Dec;26(12):1291-1296
pubmed: 28262339
JAMA. 2017 Mar 14;317(10):1057-1067
pubmed: 28291892
J Stroke Cerebrovasc Dis. 2014 Apr;23(4):724-31
pubmed: 23910512
Neurol Neurochir Pol. 2013 Jul-Aug;47(4):303-9
pubmed: 23986419
J Clin Neurosci. 2013 Jul;20(7):984-7
pubmed: 23664409
JAMA. 2013 Sep 4;310(9):959-68
pubmed: 24002282
Am J Geriatr Pharmacother. 2011 Jun;9(3):143-52
pubmed: 21570361
Stroke. 2013 Oct;44(10):2808-13
pubmed: 23887834
Rural Remote Health. 2014;14(4):2867
pubmed: 25494905
Int J Stroke. 2018 Dec;13(9):949-984
pubmed: 30021503
Lancet. 2014 Jan 18;383(9913):245-54
pubmed: 24449944
Eur J Neurol. 2006 Mar;13(3):220-4
pubmed: 16618336
Lancet. 1998 Oct 17;352(9136):1245-51
pubmed: 9788453
Neuroimaging Clin N Am. 2011 May;21(2):407-23, xii
pubmed: 21640307
Acta Neurol Scand. 2012 Sep;126(3):171-7
pubmed: 22077692
Stroke. 2019 Dec;50(12):e344-e418
pubmed: 31662037
J Neurol Sci. 2006 May 15;244(1-2):143-50
pubmed: 16530226