Letters Thrombolysis in elderly people

Observational data insufficient to change treatment

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d306 (Published 19 January 2011) Cite this as: BMJ 2011;342:d306
  1. Richard I Lindley, professor of geriatric medicine1,
  2. Joanna M Wardlaw, professor and honorary consultant neuroradiologist2,
  3. Peter A G Sandercock, professor of medical neurology and honorary consultant neurologist2
  1. 1University of Sydney, NSW 2006, Australia
  2. 2Western General Hospital, University of Edinburgh, Edinburgh EH4 2XU, UK
  1. richard.lindley{at}sydney.edu.au

The paper by Mishra and colleagues suggests that age should not be a barrier to stroke thrombolysis,1 but caution is advised when using observational data to change clinical practice.

SITS is a voluntary register, so does not include all patients who receive recombinant tissue plasminogen activator (rt-PA), and those who have adverse events (such as haemorrhage and death) may be omitted. VISTA is a trials registry, so includes all patients without selective loss. Therefore a …

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