Abstract
Objective: To evaluate the outcomes of thrombolytic therapy in elderly patients with acute ischemic stroke treated at Nghe An Friendship General Hospital.
Subjects and Methods: A prospective descriptive study was conducted on 82 elderly patients with acute ischemic stroke who were treated with Alteplase at Nghe An Friendship General Hospital from July 15, 2024 to March 31, 2025.
Results: The proportion of males was higher than that of females, with a male-to-female ratio of 1.28:1. The mean age was 73.65 ± 9.12 years. The mean NIHSS score at admission was 10. The NIHSS group of 6–15 points was the most common (78%), while the group with NIHSS ≥16 points accounted for only 6.1%. The mean ASPECTS score at admission was 8.98, with a median of 9. After 3 months, the rate of good functional outcome (mRS 0–2) was 61%. Patients aged 60–79 years had a 3.44-fold higher likelihood of good neurological recovery after 90 days compared with those aged ≥80 years, and the difference was statistically significant (p = 0.019). Patients with an admission NIHSS score <10 had a 3.2-fold higher probability of achieving a good clinical outcome after 90 days compared with those with NIHSS ≥10 (p = 0.017). Patients with large vessel occlusion had a 9-fold higher risk of poor functional outcome (mRS >2) after 90 days compared with those without large vessel occlusion, and the difference was statistically significant (p < 0.05).
Conclusion: Advanced age increases the risk of acute ischemic stroke. Most patients receiving thrombolytic therapy achieved good clinical outcomes after 90 days. An admission NIHSS score <10 and ASPECTS of 9–10 were favorable prognostic factors for clinical outcomes at 90 days. Large vessel occlusion was associated with poor clinical outcomes after 90 days.