Older Women Benefit from Thrombolysis as Much as Older Men

Abstract

Background: Although the incidence of stroke among older people increases, the use of intravenous thrombolysis has initially been restricted in the elderly. However, more people aged more than 80 years, a majority of them women, may benefit from thrombolysis. Therefore characteristics, outcome, and complications in older women (aged more than 80 years) undergoing thrombolysis are studied and compared to older men and to younger women (aged less than 80 years) to detect any gender and age differences.

Methods: Retrospective study of stroke patients treated with thrombolysis based on data collected from medical records. Outcome and complications were analyzed in 3 groups in relation to age and gender.

Results: From a total of 108 patients treated with thrombolysis, 94 could be included in the study (36 women ≥80 years, 23 men ≥80 years, and 35 women <80 years). Improvement over the first 24 hours and at 3 months, and mortality were comparable between older women and men. Older women had more major strokes, a higher mortality, and 3-month morbidity than younger women. There was no significant difference in intracranial hemorrhage between the groups.

Conclusions: We found no significant difference between older women and men in outcome and mortality after thrombolysis. Older women suffered from more severe strokes, and had a higher mortality and worse outcome than younger women. The frequency of intracranial hemorrhage was comparable. Given the higher percentage of older women suffering from more severe strokes, our results emphasize that thrombolysis should not be withheld exclusively based on age.

Keywords: Age; alteplase; elderly; gender; ischemia; stroke; thrombolysis; women.