Clinical efficacy of intravenous rt-PA thrombolytic therapy in elderly patients with cerebral infarction

Objective To assess the clinical efficacy of intravenous rt-PA thrombolytic therapy in elderly patients with cerebral infarction. Methods Clinical data of 78 elderly (age ≥ 80 years) patients with acute cerebral infarction were analyzed retrospectively. The patients were divided into either a good-outcome group (mRS≤2) or a poor-outcome group (mRS>2) according to the mRS score. These data were statistically described, and the factors influencing prognosis of intravenous rt-PA thrombolytic therapy in elderly patients with acute cerebral infarction were analyzed by multivariate Logistic regression analysis. Results Statistical analyses showed that baseline GCS score [(13.33±2.04) vs (11.50±3.47), t=2.812, P=0.007], baseline NIHSS score [(9.55±6.01) vs (15.63±8.29), t=-3.694, P<0.001], 24-h GCS score [(14.48±0.99) vs (11.74±3.51), t=4.640, P<0.001], 24-h NIHSS score [(4.80±3.83) vs (15.76±9.69), t=-6.509, P<0.001], previous antiplatelet status (1 case vs 8 cases, χ2=6.571, P=0.010); cerebral hemorrhage (0 cases vs 4 cases, χ2=4.438, P=0.035), and death (0 cases vs 14 cases, χ2=17.961, P<0.001) had a significant difference between the poor-outcome and good-outcome groups. Multivariate Logistic regression analysis showed that diastolic pressure before thrombolysis, blood glucose before thrombolysis, and 24-h NIHSS score independent influential factors for prognosis of thrombolytic therapy. Conclusion Improving 24-h NIHSS score, blood sugar before thrombolysis, and diastolic blood pressure before thrombolysis can improve the prognosis of venous rt-PA thrombolysis in elderly patients with cerebral infarction. Key words: Cerebral; Infarction; Elderly; Intravenous thrombolysis