Tạp Chí Y Học Việt Nam · Aug 10, 2026
Efficacy and safety of intravenous thrombolysis in older patients with acute ischemic stroke
By Lê ĐĐM, Hà MC, Đinh QB et al.
BACKGROUND: Acute ischemic stroke is a leading cause of death and disability worldwide. Intravenous thrombolysis with alteplase is currently the standard treatment within the first 4.5 hours. However, the efficacy and safety of this treatment in older adults remain controversial in clinical practice. OBJECTIVE: To compare the efficacy and safety of intravenous thrombolysis between patients aged ≥ 65 years and those aged < 65 years. METHODS: A descriptive cross-sectional study was conducted in 52 patients with acute ischemic stroke treated with intravenous alteplase infusion at Nguyen Trai Hospital. Patients were divided into two groups by age. Clinical and paraclinical characteristics, treatment efficacy, and safety were collected and analyzed using appropriate statistical tests. RESULTS: Patients aged ≥ 65 years had statistically significantly higher NIHSS scores on admission than those aged < 65 years (12.5 versus 6.0; p = 0.003). The rate of good neurological functional recovery, corresponding to mRS 0–1 at 3 months, was lower in the group aged ≥ 65 years (46.2% versus 76.9%; p = 0.023). The mortality rate was significantly higher in the group aged ≥ 65 years (30.8% versus 7.7%; p = 0.035). No significant difference in the rate of intracranial hemorrhage was observed between the two groups. CONCLUSIONS: Intravenous thrombolysis still provides clinical improvement in both age groups. However, patients aged ≥ 65 years have a poorer prognosis, with a higher mortality rate and a lower likelihood of functional recovery.