Yuji Kato1, Takeshi Hayashi2, Yuito Nagamine2, Norio Tanahashi2, Shotai Kobayashi3. 1. Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama, Japan. Electronic address: yujik@saitama-med.ac.jp. 2. Department of Neurology and Cerebrovascular Medicine, Saitama International Medical Center, Saitama Medical University, Saitama, Japan. 3. Department of Neurology, Shimane University, Shimane, Japan.
Abstract
BACKGROUND: Japan has the fastest aging society in the world. Compared with younger patients, older ones have a different stroke risk profile and different stroke features. The aim of this study was to examine the risk factor profiles, stroke severities, and functional outcomes of hypertensive intracerebral hemorrhage (ICH) in different age groups. METHODS: A total of 14,599 patients with hypertensive ICH were included in a multicenter, hospital-based registration study using a computerized database involving 95 Japanese institutes from 2000 to 2012. RESULTS: The frequencies of atrial fibrillation, previous stroke, and coronary artery disease peaked in patients in their 80s and decreased thereafter. The frequency of the use of antithrombotic agents increased with age and reached its peak (26.7%) in patients in their 80s and sustained 18.6% in patients aged 90 years or older. More severe symptoms on admission and worse functional outcomes were observed with an increase in age, which might be related with the increased rate of antithrombotic therapy. CONCLUSIONS: The rate of use of antithrombotic agents increases with age. The role of these agents in ICH becomes larger in aged people, which may be one of the causes of poorer outcome in aged patients with ICH. Given that the population is rapidly aging, the use of antithrombotic agents should be considered an emerging risk factor.
BACKGROUND: Japan has the fastest aging society in the world. Compared with younger patients, older ones have a different stroke risk profile and different stroke features. The aim of this study was to examine the risk factor profiles, stroke severities, and functional outcomes of hypertensive intracerebral hemorrhage (ICH) in different age groups. METHODS: A total of 14,599 patients with hypertensive ICH were included in a multicenter, hospital-based registration study using a computerized database involving 95 Japanese institutes from 2000 to 2012. RESULTS: The frequencies of atrial fibrillation, previous stroke, and coronary artery disease peaked in patients in their 80s and decreased thereafter. The frequency of the use of antithrombotic agents increased with age and reached its peak (26.7%) in patients in their 80s and sustained 18.6% in patients aged 90 years or older. More severe symptoms on admission and worse functional outcomes were observed with an increase in age, which might be related with the increased rate of antithrombotic therapy. CONCLUSIONS: The rate of use of antithrombotic agents increases with age. The role of these agents in ICH becomes larger in aged people, which may be one of the causes of poorer outcome in aged patients with ICH. Given that the population is rapidly aging, the use of antithrombotic agents should be considered an emerging risk factor.