AIM: Stroke is common in older people. The objective of the study was to determine if older stroke patients have a higher mortality and disability compared with younger patients for comparable stroke severity and pathology and whether there is an explanation for the difference. METHODS: A prospective study was undertaken in 296 consecutive patients admitted with acute stroke. Patients were studied for neurological features, pre-stroke functional disability, severity of stroke defined by stroke syndromes and pathology of stroke on CT scans (202 patients). Post-stroke disability was defined according to the functional status within 72 h of admission. A record was made of the intercurrent illness while the patients were in acute wards and of the risk factors. Patients were dichotomized into two age groups: younger group - up to 75 years (163 patients) and older group - over 75 years (133 patients). Outcome was measured according to (1) discharge status from acute wards, i.e., dead or alive, and (2) mortality at 3 months. RESULTS: Although there was no significant difference in severe clinical stroke syndromes (p = 0.72), CT scan features (p = 0.68) and pyrexia (0.38) between the two age groups, the older patients had significantly more disabling strokes as defined on Barthel Index (p = 0.015) and a higher mortality in the acute phase (p < 0.01) and at 3 months (p = 0.001). The older stroke patients had more severe pre-stroke disability (p < 0.001) and more severe neurological impairment for similar stroke severity and pathology. Early mortality was more influenced by pre-stroke global health than age whereas 3-month mortality was influenced by age to the exclusion of all other known prognostic factors. CONCLUSION: The older stroke patients have more disabling stroke and an increased mortality for a similar spectrum of stroke severity and pathology. The explanation for higher mortality of the older patients is the poor pre-stroke health and higher immediate post-stroke disability.
AIM: Stroke is common in older people. The objective of the study was to determine if older strokepatients have a higher mortality and disability compared with younger patients for comparable stroke severity and pathology and whether there is an explanation for the difference. METHODS: A prospective study was undertaken in 296 consecutive patients admitted with acute stroke. Patients were studied for neurological features, pre-stroke functional disability, severity of stroke defined by stroke syndromes and pathology of stroke on CT scans (202 patients). Post-stroke disability was defined according to the functional status within 72 h of admission. A record was made of the intercurrent illness while the patients were in acute wards and of the risk factors. Patients were dichotomized into two age groups: younger group - up to 75 years (163 patients) and older group - over 75 years (133 patients). Outcome was measured according to (1) discharge status from acute wards, i.e., dead or alive, and (2) mortality at 3 months. RESULTS: Although there was no significant difference in severe clinical stroke syndromes (p = 0.72), CT scan features (p = 0.68) and pyrexia (0.38) between the two age groups, the older patients had significantly more disabling strokes as defined on Barthel Index (p = 0.015) and a higher mortality in the acute phase (p < 0.01) and at 3 months (p = 0.001). The older strokepatients had more severe pre-stroke disability (p < 0.001) and more severe neurological impairment for similar stroke severity and pathology. Early mortality was more influenced by pre-stroke global health than age whereas 3-month mortality was influenced by age to the exclusion of all other known prognostic factors. CONCLUSION: The older strokepatients have more disabling stroke and an increased mortality for a similar spectrum of stroke severity and pathology. The explanation for higher mortality of the older patients is the poor pre-stroke health and higher immediate post-stroke disability.
Authors: Yince Loh; D Kim; Z-S Shi; S Tateshima; P M Vespa; N R Gonzalez; S Starkman; J L Saver; R Jahan; D S Liebeskind; G R Duckwiler; F Viñuela Journal: AJNR Am J Neuroradiol Date: 2010-04-15 Impact factor: 3.825
Authors: Tanzila Shams; Alexander P Auchus; Suzanne Oparil; Clinton B Wright; Jackson Wright; Anthony J Furlan; Cathy A Sila; Barry R Davis; Sara Pressel; Jose-Miguel Yamal; Paula T Einhorn; Alan J Lerner Journal: Stroke Date: 2017-09-27 Impact factor: 7.914
Authors: D Kim; G A Ford; C S Kidwell; S Starkman; F Vinuela; G R Duckwiler; R Jahan; J L Saver Journal: AJNR Am J Neuroradiol Date: 2007-01 Impact factor: 3.825
Authors: Natalia S Rost; Pedro Cougo; Svetlana Lorenzano; Hua Li; Lisa Cloonan; Mark Jrj Bouts; Arne Lauer; Mark R Etherton; Hasan H Karadeli; Patricia L Musolino; William A Copen; Ken Arai; Eng H Lo; Steve K Feske; Karen L Furie; Ona Wu Journal: J Cereb Blood Flow Metab Date: 2017-05-08 Impact factor: 6.200
Authors: Daniel C Morris; Wing Lee Cheung; Richard Loi; Talan Zhang; Mei Lu; Zheng G Zhang; Michael Chopp Journal: Neurosci Lett Date: 2017-08-31 Impact factor: 3.046