Age and Gender Differences in Acute Stroke Hospital Patients

Abstract

SUMMARY -Stroke is the second leading cause of death and the most important cause of adult disability worldwide and in Croatia. In the past, stroke was almost exclusively considered to be a disease of the elderly; however, today the age limit has considerably lowered towards younger age. The aim of this study was to determine age and gender impact on stroke patients in a Croatian urban area during one-year survey. The study included all acute stroke patients admitted to our Department in 2004. A compiled stroke questionnaire was fulfilled during hospitalization by medical personnel on the following items: stroke risk factors including lifestyle habits (smoking and alcohol), pre-stroke physical ability evaluation, stroke evolution data, laboratory and computed tomography findings, outcome data and post-stroke disability assessment. Appropriate statistical analysis of numerical and categorical data was performed at the level of p<0.05. Analysis was performed on 396 patients, 24 of them from the younger adult stroke group. Older stroke patients had worse disability at hospital discharge and women had worse disabilities at both stroke onset and hospital discharge, probably due to older age at stroke onset. Younger patients recovered better, while older patients had to seek secondary medical facilities more often, as expected. The most important in-hospital laboratory findings in young stroke patients were elevated lipid levels, while older patients had elevated serum glucose and C-reactive protein. Stroke onset in younger patients most often presented with sudden onset headache; additionally, onset seizure was observed more frequently than expected. Stroke risk factor analysis showed that women were more prone to hypertension, chronic heart failure and atrial fibrillation, whereas men had carotid disease more frequently, were more often smokers and had higher alcohol intake. Additionally, age analysis showed that heart conditions and smoking were more prevalent among older stroke patients. In conclusion, considerable differences were established between age and gender stroke patient groups, confirming the need of permanent national stroke registry and subsequent targeted action in secondary care, and prevention with education on risk factors, preferably personally tailored.

The Impact of Comorbidity on Rehabilitation Outcome After Ischemic Stroke

“…Some claim that AH has a negative impact, whereas others consider that it increases the length of hospital stay but has no significant influence on the rehabilitation outcome ( 13 - 15 ). AH is most frequently associated with lacunar IS, which confirms that the substrate in the development of this type of IS are changes in small penetrating arteries ( 16 ).…”

“…AF is considered a predictor of poor outcome of medical rehabilitation, increased dependency in ADL, and a cause of more frequent institutionalization ( 25 - 27 ). AF frequently concurs with large cortical brain infarctions, and therefore this heart dysfunction is associated with poor rehabilitation outcome ( 16 ). AF increases five times the risk of lethal outcome during medical rehabilitation and represents one of the most common reasons for disruption of treatment ( 28 ).…”

Clinical/epidemiological characteristics of ischemic stroke in Dagestan

“…Несмотря на то что среди женщин сочетание указанных заболеваний встречалось чаще, контроль АД и гликемии у них оказался более значительным. У большой части обследованных имел место синдром гиперкоагуляции, что в сочетании с атеросклеротическим поражением церебральных и прецеребральных артерий явилось причиной атеротромботического ИИ [7]. Следует отметить, что признаки гиперкоагуляции чаще встречались у женщин.…”

Effect of the Size of the Left Atriumo Sustained Sinus Rhythm in Patients Undergoing Mitral Valve Surgery and Concomitant Bipolar Radiofrequency Ablation for Atrial Fibrillation

“…It is a global healthcare problem and with the ongoing aging of the general population, its prevalence and incidence is estimated to double in the next 50 years [2][3][4] . It has major medical and economic implications, as it is associated with compromised cardiac function, systemic embolization, and complications associated with anticoagulant therapy, resulting in higher mortality, morbidity, and prolonged hospital stay [4][5][6][7][8] . Th e traditional anti-arrhythmic medications for AF are limited in long-term effi ciency and have signifi cant and sometimes fatal adverse events 9 .…”

“…As a consequence, bipolar radiofrequency ablation (RFA) has been established as a simple, eff ective and safe alternative method capable of creating fast transmural tissue lesions of the atrial myocardium 16,17 . It provides a shorter time of surgery and reduces the risk of perioperative complications 6,7,12,13 .…”