Use of the clot busting drug tissue plasminogen activator for ischemic stroke has increased for every age group in recent years. But the magnitude of change has been greatest among the very elderly, 80 years and older, researchers report at the American Stroke Association’s International Stroke Conference 2015.
Historically, rates of tPA administration in patients ages 80 years and older have been lower than the general population.
Researchers analyzed the health records of nearly 6 million patients admitted to U.S. hospitals between 2000 and 2010. This included patients with an ischemic stroke diagnosis, who received tPA.
Study participants were 35 percent 80 years and older, 37 percent 65 to 79 years of age, and 28 percent were 18 to 64.
They found that tPA administration rate increases from 2000 to 2010 were:
- 0.47 to 3.55 percent for the oldest group studied;
- 0.92 to 3.87 percent for 65 to 79 year olds; and
- 1.02 to 3.61 percent in patients ages 18 to 64.
Among 80 year-old and older individuals:
- Those treated at an urban hospital and teaching hospital were more likely to receive tPA.
- Women, Blacks, Hispanics and Medicaid holders were less likely to receive tPA.
Ways to improve safe and effective tPA administration among very elderly stroke patients should be explored, researchers said.