Outcome of intravenous recombinant tissue plasminogen activator for acute ischemic stroke in patients aged over 80 years

Aim Practitioners are faced with a substantial challenge when considering recombinant tissue plasminogen activator (rt‐PA) therapy for older patients with ischemic stroke. Patients aged over 80 years suffer from the most severe cerebral infarcts. The benefit of rt‐PA treatment compared with single standard care only in stroke units remains to be clearly assessed. Methods We collected data from 321 patients aged over 80 years admitted for acute cerebral infarction to the stroke unit of Nancy University Hospital in France between 1 January 2009 and 31 December 2012. Patients were stratified into two groups: treated or not with rt‐PA. Baseline characteristics and outcome were collected and compared between both groups. Good outcome at 3 months was defined as modified Rankin Scale score ≤2. Results The 55 patients treated with rt‐PA had a higher National Institute of Health Stroke Scale score on admission than those without (15 vs 5; P