Intravenous tissue plasminogen activator for acute ischemic stroke in patients ≥80 years old: The London, Canada experience
Bibliographic record
Abstract
P163 Background: Although, elderly patients (≥80 years) are not excluded from receiving tPA for acute ischemic stroke (AIS), uncertainty still exists regarding the effectiveness and safety of tPA in this age group. Objective: To compare baseline characteristics, outcomes, and complications of AIS patients treated with iv tPA aged ≥80 with their younger counterparts ( Methods: Patients ≥80 were compared to the younger group aged 1/3 middle cerebral artery territory was involved. Findings: To date 62 patients have been treated. Median ages of the young group (n=46) are 68 years (range of 37–79) and of the older group (n=16) are 85 years (range of 80–93). Thirty-one of 46 younger patients and eleven of 16 older patients have reached the 3 month follow-up mark. The elderly group had a statistically significant higher mean pre-stroke Modified Rankin Score (mRS) of 1.5 compared to 0.6 for the younger group (p=0.01). The mean initial National Institutes of Health Stroke Scale Scores (NIHSSS), and mean time to tPA from stroke onset do not differ significantly: 14 (young) and 17 (old) (p=0.07), and 151 minutes (young) and 155 minutes (old) (p=0.67). Percent of patients achieving ≥4 point improvement in NIHSS 24 hours post tPA, a 3 month NIHSS of 0–1, and a 3 month MRS of 0–1 are 63 V.S. 44 (p=0.29), 35 V.S. 36 (p=0.80)and 41 V.S. 9 (p=0.12) for the young and old groups respectively. Only one patient (age 81) had a fatal intracranial hemorrhage (ICH). No other patients in the registry suffered a symptomatic ICH. Of the younger group, 11% and of the elderly group, 19% had an asymptomatic ICH (p=0.71). Conclusions: Despite the elderly patients having greater pre-stroke disability, iv tPA for AIS in this group does not significantly differ in effectiveness and complications compared to the same treatment in patients under age 80. TPA should not be withheld from AIS patients on the basis of age alone.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".