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Thrombolysis in acute ischemic stroke in patients with dementia: A Swedish registry study
Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Huddinge, Sweden; Department of Neurology, University Medical Centre, Ljubljana, Slovenia.
Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, and Department of Medicine, Solna, Sweden; Karolinska University Hospital, Aging Research Center, Stockholm, Sweden.
Department of Clinical Pharmacology; Karolinska Institutet and Stockholm University, Aging Research Center, Stockholm, Sweden; Institute of Gerontology, School of Health and Welfare, Aging Research Network-Jönköping, Jönköping University, Jönköping, Sweden.
Department of Neurobiology, Care Sciences and Society, Center for Alzheimer Research, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden; Department of Geriatrics, Hospital Universitario de Getafe, Madrid, Spain.
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2017 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 89, no 18, p. 1860-1868Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To compare access to intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) and its outcomes in patients with and without dementia.

METHODS: This was a longitudinal cohort study of the Swedish dementia and stroke registries. Patients with preexisting dementia who had AIS from 2010 to 2014 (n = 1,356) were compared with matched patients without dementia (n = 6,755). We examined access to thrombolysis and its outcomes at 3 months (death, residency, and modified Rankin Scale [mRS] score). Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated with logistic and ordinal logistic regression.

RESULTS: < 0.001). Unfavorable outcomes with an mRS score of 5 to 6 were doubled in patients with dementia (56.1% vs 28.1%).

CONCLUSIONS: Younger patients with dementia and AIS are less likely to receive IVT. Among patients receiving thrombolysis, there are no differences in sICH or death, although patients with dementia have worse accommodation and functional outcomes at 3 months.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2017. Vol. 89, no 18, p. 1860-1868
National Category
Medical and Health Sciences Cardiac and Cardiovascular Systems
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URN: urn:nbn:se:oru:diva-80719DOI: 10.1212/WNL.0000000000004598ISI: 000417674500011PubMedID: 28986410Scopus ID: 2-s2.0-85032826460OAI: oai:DiVA.org:oru-80719DiVA, id: diva2:1415426
Available from: 2020-03-18 Created: 2020-03-18 Last updated: 2020-03-24Bibliographically approved

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