Acute ischemic stroke in the very elderly outcome and predictive factors / 中华内科杂志

ABSTRACT

ObjectiveTo investigate the clinical characteristics,3-month outcome and predictive factors in the very elderly patients with ischemic stroke.MethodsA total of 305 acute ischemic patients aged 65 years and over were enrolled in the study.They were divided into two subgroups by age80 years old and over(n =78),65-79 years old(n =227).The clinical outcome was assessed by the modified Rankin Scale (mRS) on (90 ± 7 ) days after stroke,and categorized as good ( scoring 0-2 ) or poor( scoring 3-6) outcome.Results Significantly lower BMI [ ( 23.62 ± 4.92 ) kg/m2 vs ( 25.08 ± 3.69 ) kg/m2,P =0.005],lower frequency of dyslipidemia(56.41％ vs 71.13％,P =0.006) and alcohol intake (0％ vs 6.61％,P =0.043 )were found in the very elderly group.The rates of poor functional outcome in the ≥ 80years group and the 65-79 years old group were 56.41％ (44/76) and 41.40％ (94/224) respectively,with a P value of 0.015.Multivariate logistic regression analysis showed that higher National Institute of Health stroke scale (NItISS) total score (OR 1.48,95％ CI 1.19-1.83 ) and lower albumin level (OR 0.73,95 ％ CI 0.55 -0.95 ) were associated with poor outcome in ≥ 80 year old,whereas higher NIHSS total score ( OR 1.38,95％ CI 1.24-1.53) and complications during hospital stay ( OR 2.58,95％ CI 1.07-6.19 ) were predictive factors in the 65-79 years old group.ConclusionOur study suggests that NIHSS scores,albumin level and complications during hospitalization are useful predictive factors for the short-term poor functional outcome in the patients of ≥65 years old and ≥80 years old patients have a worse prognosis.