Hypertensive intracerebral hemorrhage in the very elderly.
BACKGROUND
The number of persons reaching the age 80 years and over is increasing in most populations. Literature focusing on hypertensive intracerebral hemorrhage (ICH) in this age group is lacking. Therefore, we aimed to analyze the main clinical characteristics of ICH of the advanced old age, in the context of hypertension.


METHODS
From 1999 to 2003 we studied 56 hypertensive very elderly patients presenting with ICH (50% women; age 80-99 years). As controls, 168 hypertensive gender-matched persons with ICH, aged <80 years, were randomly selected by a 3:1 factor for clinical comparisons.


RESULTS
Compared with their younger counterparts, the very elderly patients had a trend for fewer cases of obesity (34 vs. 49%, p = 0.05) and diabetes mellitus (12 vs. 24%, p = 0.06), had lower systolic, diastolic and mean blood pressure measures (in all, p < 0.01) and more cases with hematoma extension into ventricles (p = 0.02). Thalamic hemorrhage was more frequent in the very elderly patients than in controls (43 vs. 28%, p = 0.04). In multivariate analysis, age, Glasgow coma scale score at hospital admission, ICH volume and infratentorial location were independent predictors of in-hospital mortality, in all persons combined. In the very elderly group exclusively, Glasgow coma scale score was the only factor independently associated with mortality.


CONCLUSIONS
ICH occurring in hypertensive patients aged > or =80 years has several differences from that seen in younger people; however, these differences do not seem to impact on early outcome.
Chiquete
Erwin
E
Department of Neurology and Neurosurgery, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, México.
Ruiz-Sandoval
M Carmen
MC
Alvarez-Palazuelos
Lucía E
LE
Padilla-Martínez
Juan J
JJ
González-Cornejo
Salvador
S
Ruiz-Sandoval
José L
JL
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D020299:Intracranial Hemorrhage, Hypertensive / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000503:physiopathology; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index