Clinical and Radiological Characteristics of Ischemic Stroke in the 80 Year-Old or Older: A Single Center Study

Lim, Eun Ye; Wang, Min Jeong; Park, Hyung Eun; Choi, Eu Jene; Lee, Ji Yeon; Kim, Woojoon; Cho, A Hyun

Abstract

BACKGROUND
The risk profiles and stroke presentations may differ between elderly stroke patients and their younger counterparts. The most appropriate stroke-management regime for a better outcome can only be achieved with knowledge of the characteristics of elderly stroke patients. This study compared the clinical and radiological characteristics of elderly (> or =80 years) ischemic stroke patients with those aged <80 years.
METHODS
Consecutive acute ischemic stroke patients were enrolled. The following parameters were obtained for each patient: clinical variables [i.e., risk factors, initial National Institutes of Health Stroke Scale (NIHSS) score, mode of onset, in-hospital complications, and modified Rankin scale (mRS) score at 3 months], radiological variables, and clinicoradiological discrepancies.
RESULTS
Of the 436 enrolled patients, 60 (13.8%) were elderly. The proportion of men was lower among the elderly than among those patients aged >80 years (40.0% vs. 63.3%; p=0.001), while their initial NIHSS score was higher (median, 4 vs. 3; p=0.033). Furthermore, an unclear stroke onset (46.4% vs. 32.8%; p=0.049) and clinicoradiological discrepancies (13.8% vs. 5.7%; p=0.044) were more common among the elderly. The proportions of subjects with stroke of undetermined cause (30.0% vs. 18.0%; p=0.019) and multiple circulation infarctions (23.3% vs. 12.6%, p=0.030) were higher among the elderly. A favorable outcome (mRS score of 0 or 1) was more common in the younger stroke patients (57.5% vs. 25.9%, p<0.0001). Multivariate analysis revealed that younger age, male gender, and initial stroke severity were significantly associated with a favorable outcome.
CONCLUSIONS
These results indicate that stroke presentation in the elderly differs from that of their younger counterparts in terms of clinical and radiological variables.