Acute ischemic stroke in the very elderly Chinese: Risk factors, hospital management and one-year outcome

Wang, Deren; Zeng, Hao; Tao, Wendan; Kong, Fanyi; Zhang, Shihong; Wu, Bo; Lin, Sen; Liu, Ming

doi:10.1016/j.clineuro.2011.01.005

Cited by 31 publications

(31 citation statements)

References 32 publications

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“…To the best of our knowledge, this is the first triennially repeated observation of the same population showing a significant trend of increasing proportion of very elderly subjects among stroke patients. In China, the proportion of the very elderly in hospitalized stroke patients has been reported lower than that in western countries [12]. Moreover, in a report from Taiwan, the percentage of old Asian stroke patients decreased from 2002 to 2005 despite the increase in the total number of stroke patients [3].…”

Section: Discussionmentioning

confidence: 99%

“…Whereas in several studies the age cutoff for old stroke patients is 70 years [7,8], in others, it varies from 75 to 88 years [9,10]. Moreover, elderly stroke patients in most studies have been compared with the entire population of younger patients, although it is well known that young (aged ≤55 years) stroke patients share specific etiological and prognostic features different from those of older patients [11,12,13]. Our aim was to study patient characteristics, clinical features and outcomes in the very elderly (aged ≥ 85 years) in comparison with patients aged 65–84 years with a first-ever ischemic stroke in the prospective National Acute Stroke Israeli Surveys (NASIS) registry.…”

Section: Introductionmentioning

confidence: 99%

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Stroke in the Very Elderly: Characteristics and Outcome in Patients Aged ≥85 Years with a First-Ever Ischemic Stroke

et al. 2012

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Background: Epidemiological and clinical features of very elderly patients with stroke are still uncertain. Our aim was to study the patient characteristics and outcomes in the very elderly (aged ≥85 years) with a first-ever ischemic stroke in the National Acute Stroke Israeli Survey (NASIS) registry. Methods: The NASIS registry is a nationwide prospective hospital-based study performed triennially (2004, 2007, 2010). Patients with ischemic stroke aged ≥85 years were compared with those 65–84 years old regarding their baseline characteristics, stroke severity, etiology of stroke and stroke outcomes. Logistic regression analyses were used to adjust for potential confounders. Stroke severity was determined according to the National Institute of Health Stroke Scale (NIHSS) score. Results: The proportion of very elderly (≥85 years) patients among the NASIS population increased from 18.3% in 2004 to 19.9% in 2007 and 24.5% in 2010 (p for trend = 0.005). The percentage of women was higher in patients aged ≥85 years (p < 0.0001). Atrial fibrillation, congestive heart disease and prior disability were significantly more common, while diabetes, current smoking and dyslipidemia were less frequent in the very elderly. The very elderly presented with more severe strokes: 36.3% of the ≥85-year-old patients had an NIHSS score ≥11 compared with 22.0% in the younger age group (p < 0.05). Conclusions: There is an increasing proportion of very elderly subjects, mostly women, among first-ever ischemic stroke patients. Current information on age-specific aspects of stroke in the very elderly is crucial to set up successful prevention pathways and implementing well-organized stroke care for this population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Stroke in the Very Elderly: Characteristics and Outcome in Patients Aged ≥85 Years with a First-Ever Ischemic Stroke

et al. 2012

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“…Stroke can affect individuals of any age, although the incidence and prevalence of this disease increase sharply with age [4]. Prior data from both western countries and China disclose a higher incidence of ischemic stroke in men than in women in patients under 80, however, most very old patients with stroke (aged >80 years) are women [5, 6]. In addition, disparities exist in risk factors, clinical presentation, and outcomes of stroke among patients with different ages and genders [6–11].…”

Section: Introductionmentioning

confidence: 99%

Age- and Gender-Specific Prevalence of Risk Factors in Patients with First-Ever Ischemic Stroke in China

Yao

Lin

Geng

et al. 2012

Stroke Research and Treatment

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Background. Evidences are accumulating that age and gender have great impact on the distribution of stroke risk factors. Such data are lacking in Chinese population. Methods. 1027 patients with first-ever ischemic stroke (IS) were recruited and divided into young adult (<50 years), middle-aged (50∼80 years), and very old (>80 years) groups according to stroke onset ages. Vascular risk factors were collected and compared among groups. Results. Female patients were globally older than male patients at stroke onset and having higher prevalence of diabetes mellitus (DM), heart diseases, and atrial fibrillation (AF). However, females were less likely to drink heavily or smoke than males. Young patients had a much higher proportion of smoking and drinking than middle-aged and very old patients and the highest family history of hypertension, while very old patients had the highest prevalence of heart diseases and AF but lowest proportion of positive family history of vascular diseases. Hypertension and DM were equally frequent among three groups. Conclusion. Our study showed that vascular risk factors had a specific age and gender distribution pattern in Chinese IS patients. Secondary prevention strategy should emphasize on the control of different risk factors based on patient's age and gender.

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“…Details of the Chengdu Stroke Registry have been described previously. 10,11 In the present study, we included patients admitted within 1 month after stroke onset from January 2003 to February 2007. Patients who refused to participate in the registry and refused to be followed-up were excluded.…”

Section: November 2012mentioning

confidence: 99%

“…13 Other vascular risk factors surveyed in this study included hypertension, diabetes mellitus, hyperlipidemia, coronary heart disease, previous transient ischemic attacks, history of stroke, and current smoking and alcohol consumption, which have been described in previous reports. 10,11 Stroke severity on admission was measured using the National Institutes of Health Stroke scale (NIHSS). 14 The outcome measures were death, disability, death /disability, and recurrence at 3 months, 6 months, and 1 year after stroke.…”

Section: Definition Of Collected Data and Outcomementioning

confidence: 99%

Features of Acute Ischemic Stroke With Rheumatic Heart Disease in a Hospitalized Chinese Population

Wang

Liu

Zeng

et al. 2012

Stroke

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Background and Purpose-Rheumatic heart disease (RHD) is an important risk factor for ischemic stroke in developing countries. Observational data on its characteristics and influence on outcome or recurrence of ischemic stroke are scarce. We aimed to investigate proportions, characteristics, functional outcome, and recurrence of acute ischemic stroke patients with RHD in a hospitalized Chinese population. Methods-We prospectively enrolled consecutive patients with acute ischemic stroke who were admitted within 1 month of stroke onset from January 2003 to February 2007, into the analysis. Clinical characteristics such as age, gender, risk factors, and National Institutes of Health Stroke Scale on admission were investigated. Basic characteristics, functional outcomes, and recurrence were compared between RHD group and non-RHD group. Results-Of the 1638 cases included, RHD was present in 130 patients (7.9%). RHD patients, compared with those without RHD, were younger, more frequently female, and more often had experienced atrial fibrillation and higher National Institutes of Health Stroke Scale score on admission (all P≤0.006). After adjustment for age, sex, and National Institutes of Health Stroke Scale on admission, the death risk in patients with RHD was 2.0-fold higher at 3 months, 6 months, and 1 year compared with patients without RHD (all P≤0.013). Compared with patients without RHD, those with RHD showed a significantly higher cumulative recurrence rate (13.6% vs 6.0%; P=0.001, log rank test) by 1-year cumulative recurrent curves. Conclusions-Stroke attributable to RHD is still common in the Chinese population. RHD was associated with 2-fold increased risk of death and 1-fold increased risk of recurrence in stroke patients. (Stroke. 2012;43:2853-2857.)

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Acute ischemic stroke in the very elderly Chinese: Risk factors, hospital management and one-year outcome

Cited by 31 publications

References 32 publications

Stroke in the Very Elderly: Characteristics and Outcome in Patients Aged ≥85 Years with a First-Ever Ischemic Stroke

Stroke in the Very Elderly: Characteristics and Outcome in Patients Aged ≥85 Years with a First-Ever Ischemic Stroke

Age- and Gender-Specific Prevalence of Risk Factors in Patients with First-Ever Ischemic Stroke in China

Features of Acute Ischemic Stroke With Rheumatic Heart Disease in a Hospitalized Chinese Population

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