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Is old age really a reason to withhold thrombolytic therapy?
  1. C Schwark,
  2. P D Schellinger
  1. Department of Neurology, University of Heidelberg, Germany
  1. Correspondence to:
 Dr Peter D Schellinger
 Neurologische Universitätsklinik, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany; Peter_Schellinger{at}

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Patients eligible for thrombolysis should be treated regardless of age

Van Oostenbrugge et al (see pages 375–7) of this issue present data on a group of 45 patients aged 80 years or over and compare outcome after thrombolytic therapy to that in a group of patients aged less than 80 years. In their study, older patients have a significantly worse outcome as measured by the modified Rankin scale. There was a non-significant trend towards more intracranial bleeding in the older patients. The authors conclude that their results “question whether the use of rt-PA [recombinant tissue plasminogen activator] is justified in patients over 80 years of age”.

The authors are ambivalent with regard to thrombolytic therapy, and even more so when it comes to the treatment of elderly patients. As stated in …

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  • Dr Schellinger has received consulting fees and honoraria for presentations from Boehringer Ingelheim, Ingelheim am Rhein, Germany, the manufacturer of Actilyse (rt-PA)

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