Background and Aims: To assess the effect of thrombolysis with alteplase in the very elderly (i.e. those >90 years) with significant co-morbidities on in-hospital stay, pre and post thrombolysis Modified Rankin Score (mRS). Methods: We reviewed the treatment of stroke patients above the age of 90 years who were treated with alteplase between April 2016 to March 2017. Consideration of patients co-morbidities were taken in place with the main outcome measures being mRS, length of stay and adverse outcomes. Results: A total of 67 patients above the age of 90 years were admitted. 6 out of these 67 patients received Alteplase. Both groups had similar baseline co-morbidities (Table 1). The average length of stay was reduced in the Alteplase group (11 days vs 24 days). There were no reported adverse outcomes in either group. Conclusion Those who received Alteplase had a shorter in-hospital stay compared to those who did not. Alteplase can be safely administered even to those above the age of 90 with multiple co-morbidities. We therefore conclude, age and co-morbidity in the appropriately selected patient should not be a barrier for Alteplase therapy.
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