HIỆU QUẢ VÀ TÍNH AN TOÀN CỦA ĐIỀU TRỊ TIÊU SỢI HUYẾT ĐƯỜNG TĨNH MẠCH Ở NGƯỜI BỆNH LỚN TUỔI ĐỘT QUỴ THIẾU MÁU NÃO CẤP

Abstract

Background: Acute ischemic stroke is a leading cause of mortality and disability worldwide. Intravenous thrombolysis with alteplase is currently the standard treatment within the first 4.5 hours after symptom onset. However, the effectiveness and safety of this therapy in elderly patients remain controversial in clinical practice.

Objectives: To compare the effectiveness and safety of intravenous thrombolytic therapy between patients aged ≥ 65 years and those aged < 65 years.

Methods: A descriptive cross-sectional study was conducted on 52 patients with acute ischemic stroke treated with intravenous alteplase at Nguyen Trai Hospital. Patients were stratified into two groups according to age. Clinical characteristics, laboratory findings, treatment outcomes, and safety outcomes were collected and analyzed using appropriate statistical tests.

Results: Patients aged ≥ 65 years had significantly higher baseline NIHSS scores compared to those aged < 65 years (12.5 vs 6.0; p = 0.003). The rate of good functional outcome, defined as mRS 0–1 at 3 months, was lower in the ≥ 65 group (46.2% vs 76.9%; p = 0.023). Mortality was significantly higher in patients aged ≥ 65 years (30.8% vs 7.7%; p = 0.035). No significant difference was observed in the rate of intracranial hemorrhage between the two groups.

Conclusion: Intravenous thrombolytic therapy provides clinical benefits in both age groups. However, patients aged ≥ 65 years have poorer prognosis, with higher mortality and lower rates of functional recovery.