Clinical Characteristics of Ischemic Stroke after Octogenarian Age: A Hospital-based Study

Oh, Youn Min; Kim, Jang Sung

Abstract

BACKGROUND: Although the incidence of stroke does not decrease after 80 years of age. The significance of ischemic stroke (IS) after octogenarian age has not attracted the attention of neurologists. As a first step to investigate the significance of IS during that period, we compared the clinical characteristics of IS between OIS (octogenarian ischemic stroke group, ??80 years of age) and NOIS (non-octogenarian ischemic stroke group, 65-79 years of age). METHOD: Forty-nine OIS patients and 141 NOIS patients were recruited. Clinical characteristics including risk factors, IS subtype, Canadian Neurological Scale (CNS) score, treatment modality and short-term prognosis were evaluated and described.
RESULTS
ypertension (65.3%) was the most common risk factor followed by smoking (28.6%) and previous stroke history (28.6%) in OIS. There was no significant difference in proportion of each IS risk factors between he two groups. OIS was more associated with subtypes of mixed etiology and cardiogenic embolism than NOIS (P<.05). Subclassification by the vascular territory of IS was similar between the two groups and the middle cerebral arterial territory was the most common site (71.1%) in OIS. CNS scores on the initial neurological examination was similarly associated with both OIS (8.0 3.3) and NOIS (7.5 2.8)(P>.05). IS was more associated with poor outcome at discharge (52.2%) than NOIS (18.2%)(P<.05).
CONCLUSIONS
Ischemic stroke after octogenarian age is characterized by different etiopathogenesis and poor short-term outcome compared to IS under that age. OIS is more frequently caused by cardiogenic embolism or combined underlying etiology, however, the relationship between differences in etiopatho-genesis and poor short-term outcome remains to be clarified.