Rinsho Shinkeigaku (Clinical Neurology)

Original Article

Clinical characteristics of oldest-old patients with ischemic stroke

Shizuka Harada, M.D.1), Yuichiro Inatomi, M.D.1), Makoto Nakajima, M.D.2), Toshiro Yonehara, M.D.1) and Yukio Ando, M.D.2)

1)Department of Neurology, Saiseikai Kumamoto Hospital
2)Department of Neurology, Graduate School of Medical Sciences, Kumamoto University

We divided acute ischemic stroke patients into an oldest old group (≥90 years, n = 414) and an elderly group (75-89 years, n = 1,927), and compared the clinical characteristics between the two groups. Female sex, early admission, severe stroke on admission, atrial fibrillation, and cardioembolic stoke were significantly more frequent in the oldest-old group. On the other hand, risk factors associated with atherosclerosis were less frequent in the oldest-old group. There were no differences in hyper-acute recanalization therapy between the two groups, whereas antithrombotic therapy for secondary prevention at discharge was introduced less frequently in the oldest-old group than in the elderly group. Death prior to discharge from the acute care hospital , and death at 3 months were significantly more frequent in the oldest-old group. Moreover, in the oldest old group, severe stroke and atrial fibrillation were independent predictors for both death prior to discharge from the acute care hospital and at 3 months after onset. Oldest-old stroke patients had poor outcome, although they had received aggressive treatment as same as elderly patients. Therefore, as the number of oldest-old stroke patients is increasing, the demand for cooperation in the healthcare system is likely to grow, including acute care hospitals.
Full Text of this Article in Japanese PDF (430K)

(CLINICA NEUROL, 59: 125|132, 2019)
key words: oldest old, ischemic stroke, hyper-acute recanalization therapy, antithrombotic therapy, aging society

(Received: 21-Dec-18)