Clinical characteristics of oldest-old patients with ischemic stroke

• Published in: Rinsho Shinkeigaku Vol. 59; no. 3; pp. 125 - 132
• Main Authors: Harada, Shizuka, Inatomi, Yuichiro, Nakajima, Makoto, Yonehara, Toshiro, Ando, Yukio
• Format: Journal Article
• Language: Japanese
• Published: Japan Societas Neurologica Japonica 28.03.2019
• Subjects: aging society; antithrombotic therapy; hyper-acute recanalization therapy; ischemic stroke; oldest old; aging society; antithrombotic therapy; ischemic stroke; oldest old; hyper-acute recanalization therapy
• ISSN: 0009-918X; 1882-0654
• DOI: 10.5692/clinicalneurol.cn-001262

We divided acute ischemic stroke patients into an oldest old group (≥90 years, n = 414) and an elderly group (75–89 years, n = 1,927), and compared the clinical characteristics between the two groups. Female sex, early admission, severe stroke on admission, atrial fibrillation, and cardioembolic stoke were significantly more frequent in the oldest-old group. On the other hand, risk factors associated with atherosclerosis were less frequent in the oldest-old group. There were no differences in hyper-acute recanalization therapy between the two groups, whereas antithrombotic therapy for secondary prevention at discharge was introduced less frequently in the oldest-old group than in the elderly group. Death prior to discharge from the acute care hospital , and death at 3 months were significantly more frequent in the oldest-old group. Moreover, in the oldest old group, severe stroke and atrial fibrillation were independent predictors for both death prior to discharge from the acute care hospital and at 3 months after onset. Oldest-old stroke patients had poor outcome, although they had received aggressive treatment as same as elderly patients. Therefore, as the number of oldest-old stroke patients is increasing, the demand for cooperation in the healthcare system is likely to grow, including acute care hospitals.