Stroke in elderly patients: management and prognosis in the ED.
OBJECTIVE
The aim of the study was to analyze the effect of age on management and prognosis of stroke.


METHODS
A retrospective study was performed in consecutive patients admitted to an emergency department (ED) with a diagnosis of stroke. Comparison according to age (< 75 vs > or = 75 years old) was done, with a 1-year follow-up including autonomy and outcome.


RESULTS
In older patients, brain magnetic resonance imaging (6% vs 27%, P < .001) and immediate referral to the stroke unit were less frequent (6% vs 28%, P < .001); median length of stay was longer (11 vs 8 days, P = .007); and in-hospital mortality tended to be higher (12% vs 6%, not significant). After discharge, 1-year mortality was higher (27% vs 14%, P = .004). In a multivariate analysis, severity of stroke, hemorrhagic stroke, and dementia were independent positive predictors of 1-year mortality, whereas age was not.


CONCLUSIONS
Despite the fact that age was not an independent predictor when stroke severity was considered, our data suggest differences in the management of elderly compared with younger stroke patients admitted to the ED.
Montout
Viviane
V
Department of Emergency Medicine and Surgery, Centre Hospitalo-Universitaire Pitié-Salpêtrière, Assistance-Publique Hôpitaux de Paris, Université Pierre et Marie Curie-Paris 6, Paris, France.
Madonna-Py
Beatrice
B
Josse
Marie-Odile
MO
Ondze
Igor
I
Arhan
Amandine
A
Crozier
Sophie
S
Hausfater
Pierre
P
Riou
Bruno
B
Boddaert
Jacques
J
D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000145:classification / Q000175:diagnosis / Q000628:therapy*