TY - JOUR
T1 - Independent predictors of ischemic stroke in the elderly
T2 - Prospective data from a stroke unit
AU - Forti, Paola
AU - Maioli, Fabiola
AU - Procaccianti, Gaetano
AU - Nativio, Valeria
AU - Lega, Maria Vittoria
AU - Coveri, Maura
AU - Zoli, Marco
AU - Sacquegna, Tommaso
PY - 2013/1/1
Y1 - 2013/1/1
N2 - Objective: Incidence of ischemic stroke (IS) increases with age. Knowledge of factors associatedwith IS acute outcomes in the oldest-old ($80 years) is needed to improve quality of care and resource allocation in this age group. Methods: Data are for 769 consecutive IS patients aged$60 years (436 aged$80 years) admitted to an Italian stroke unit in a 4-year period. Demographics, prestroke disability (modified Rankin Scale $3) and comorbidities, IS etiology and subtype, NIH Stroke Scale (NIHSS) score, clinical and laboratory admission parameters, and medical complications were prospectively registered. Independent predictors of in-hospital death, incident disability, length of stay, discharge without rehabilitation, and no direct discharge home were identified by multiple logistic regression. Risk profiles before and after age 80 were compared. Results: Poor outcomes were more frequent in the oldest-old compared to the younger patients. NIHSS score, clinical parameters of IS severity (need for oxygen, indwelling catheter, or nasogastric tube), incident disability, andmedical complications predictedmost of the study outcomes in both age groups. After age 80, IS etiology and subtype proved additional independent determinants for most outcomes along with age, sex, and prestroke functional and health status. Conclusions: Characteristics related to neurologic impairment on admission were the main predictors of acute outcomes of IS in this cohort. Specific IS etiology and subtype influenced IS outcomes only after age 80. In oldest-old patients, demographics and prestroke functional and health status also influenced IS outcomes with peculiar associations.
AB - Objective: Incidence of ischemic stroke (IS) increases with age. Knowledge of factors associatedwith IS acute outcomes in the oldest-old ($80 years) is needed to improve quality of care and resource allocation in this age group. Methods: Data are for 769 consecutive IS patients aged$60 years (436 aged$80 years) admitted to an Italian stroke unit in a 4-year period. Demographics, prestroke disability (modified Rankin Scale $3) and comorbidities, IS etiology and subtype, NIH Stroke Scale (NIHSS) score, clinical and laboratory admission parameters, and medical complications were prospectively registered. Independent predictors of in-hospital death, incident disability, length of stay, discharge without rehabilitation, and no direct discharge home were identified by multiple logistic regression. Risk profiles before and after age 80 were compared. Results: Poor outcomes were more frequent in the oldest-old compared to the younger patients. NIHSS score, clinical parameters of IS severity (need for oxygen, indwelling catheter, or nasogastric tube), incident disability, andmedical complications predictedmost of the study outcomes in both age groups. After age 80, IS etiology and subtype proved additional independent determinants for most outcomes along with age, sex, and prestroke functional and health status. Conclusions: Characteristics related to neurologic impairment on admission were the main predictors of acute outcomes of IS in this cohort. Specific IS etiology and subtype influenced IS outcomes only after age 80. In oldest-old patients, demographics and prestroke functional and health status also influenced IS outcomes with peculiar associations.
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U2 - 10.1212/WNL.0b013e31827b1a41
DO - 10.1212/WNL.0b013e31827b1a41
M3 - Article
C2 - 23243075
AN - SCOPUS:84873619440
VL - 80
SP - 29
EP - 38
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 1
ER -