Outcome of first-ever acute ischemic stroke in the elderly.
Our purpose was to evaluate the outcome of patients aged 70 years or older with a first-ever acute ischemic stroke and to identify the factors which determine poor outcome. Data from 115 patients, non-disabled prior to stroke, consecutively admitted to a medical department of a teaching hospital over a 30-month period, were prospectively collected at stroke onset and 6-month follow-up. Clinical and brain imaging findings and functional status were recorded. Predictors of unfavorable outcome at 6 months, defined as a modified Rankin Scale score >2, were analyzed by multiple logistic regression. The mean age of this cohort was 78.6 years (SD, 5.7) and 66.1% were women, 73.9% had hypertension, 25.2% diabetes, 36.0% atrial fibrillation (AF), 33.9% heart failure (HF), 15.8% previous transient ischemic attack (TIA), 47.8% a Charlson comorbidity index (CCI) score >1 and 52.2% a baseline National Institute of Health stroke scale (NIHSS) score ≥ 6. At 6 months, 54 patients (47%) had unfavorable outcome and the independent predictors of poor outcome were the initial systolic blood pressure and the NIHSS score on admission. In conclusion, near 50% of these old patients were dependent or dead 6 months after stroke onset and the main predictor of poor outcome was the neurological severity of stroke.
Soares
Isabel
I
Department of Medicine IA, Egas Moniz Hospital, Rua da Junqueira, 1340-019 Lisbon, Portugal. isabel.soares@fcm.unl.pt
Abecasis
Pedro
P
Ferro
José M
JM
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011174:Portugal / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014057:Tomography, X-Ray Computed / Q000379:methods*