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Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study.
Age Ageing. 2004 Mar; 33(2):149-54.AA

Abstract

BACKGROUND AND PURPOSE

The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age as an independent predictor of short- and long-term outcome.

METHODS

In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients. Patients were stratified according to age groups on admission. Follow-up was performed at a mean of 7 years after stroke onset. By way of multiple logistic regression and survival analyses very old age was independently related to short- and long-term mortality and nursing home placement independent of other clinical characteristics.

RESULTS

16% of patients were 85 years or older at the time of stroke onset. More of the very old were women (75% versus 50%, P<0.0001), living alone (84% versus 54%, P<0.0001), had atrial fibrillation (37% versus 15%, P<0.0001), had pre-existing disability (29% versus 22%, P = 0.04), and had more severe strokes (Scandinavian Stroke Scale score 31 versus 37 points, P = 0.004). Fewer very old had hypertension (25% versus 34%, P = 0.02) and diabetes (14% versus 22%, P = 0.01). In adjusted multiple regression models, very old age predicted short-term mortality (OR 2.5; 95% CI 1.5-4.2), and discharge to nursing home or in-hospital mortality (OR 2.7; 95% CI 1.7-4.4). Five years after stroke very old age predicted mortality or nursing home placement (OR 3.9; 95% CI 2.1-7.3), and long-term mortality (HR 2.0; 95% CI 1.6-2.5). However, other factors such as onset stroke severity, pre-existing disability and atrial fibrillation were also significant independent predictors of prognosis after stroke.

CONCLUSIONS

In this study very old age per se was a strong predictor of outcome and mortality after stroke. Apart from very old age, factors such as prestroke medical and functional status, and onset stroke severity should be taken into consideration when planning treatment and rehabilitation after stroke.

Authors+Show Affiliations

Kammersgaard LP
Stroke Unit, Hvidovre University Hospital, Copenhagen, Denmark. kammersgaard@dadlnet.dk
Jørgensen HS
No affiliation info available
Reith J
No affiliation info available
Nakayama H
No affiliation info available
Pedersen PM
No affiliation info available
Olsen TS
No affiliation info available
Copenhagen Stroke Study
No affiliation info available

MeSH

Age FactorsAgedAged, 80 and overDenmarkFemaleFollow-Up StudiesHumansLogistic ModelsMalePrognosisProspective StudiesRisk FactorsStrokeSurvival AnalysisTreatment Outcome

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

14960430

Citation

Kammersgaard, Lars Peter, et al. "Short- and Long-term Prognosis for Very Old Stroke Patients. the Copenhagen Stroke Study." Age and Ageing, vol. 33, no. 2, 2004, pp. 149-54.
Kammersgaard LP, Jørgensen HS, Reith J, et al. Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study. Age Ageing. 2004;33(2):149-54.
Kammersgaard, L. P., Jørgensen, H. S., Reith, J., Nakayama, H., Pedersen, P. M., & Olsen, T. S. (2004). Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study. Age and Ageing, 33(2), 149-54.
Kammersgaard LP, et al. Short- and Long-term Prognosis for Very Old Stroke Patients. the Copenhagen Stroke Study. Age Ageing. 2004;33(2):149-54. PubMed PMID: 14960430.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short- and long-term prognosis for very old stroke patients. The Copenhagen Stroke Study. AU - Kammersgaard,Lars Peter, AU - Jørgensen,H S, AU - Reith,J, AU - Nakayama,H, AU - Pedersen,P M, AU - Olsen,T S, AU - ,, PY - 2004/2/13/pubmed PY - 2004/8/20/medline PY - 2004/2/13/entrez SP - 149 EP - 54 JF - Age and ageing JO - Age Ageing VL - 33 IS - 2 N2 - BACKGROUND AND PURPOSE: The very old are expected to become a growing part of the stroke population in the industrialised part of the world. The aims of this study were to evaluate clinical characteristics of patients aged 85 years or more at stroke onset and to investigate very old age as an independent predictor of short- and long-term outcome. METHODS: In the community-based Copenhagen Stroke Study we recorded admission clinical characteristics in 1197 consecutive stroke patients. Patients were stratified according to age groups on admission. Follow-up was performed at a mean of 7 years after stroke onset. By way of multiple logistic regression and survival analyses very old age was independently related to short- and long-term mortality and nursing home placement independent of other clinical characteristics. RESULTS: 16% of patients were 85 years or older at the time of stroke onset. More of the very old were women (75% versus 50%, P<0.0001), living alone (84% versus 54%, P<0.0001), had atrial fibrillation (37% versus 15%, P<0.0001), had pre-existing disability (29% versus 22%, P = 0.04), and had more severe strokes (Scandinavian Stroke Scale score 31 versus 37 points, P = 0.004). Fewer very old had hypertension (25% versus 34%, P = 0.02) and diabetes (14% versus 22%, P = 0.01). In adjusted multiple regression models, very old age predicted short-term mortality (OR 2.5; 95% CI 1.5-4.2), and discharge to nursing home or in-hospital mortality (OR 2.7; 95% CI 1.7-4.4). Five years after stroke very old age predicted mortality or nursing home placement (OR 3.9; 95% CI 2.1-7.3), and long-term mortality (HR 2.0; 95% CI 1.6-2.5). However, other factors such as onset stroke severity, pre-existing disability and atrial fibrillation were also significant independent predictors of prognosis after stroke. CONCLUSIONS: In this study very old age per se was a strong predictor of outcome and mortality after stroke. Apart from very old age, factors such as prestroke medical and functional status, and onset stroke severity should be taken into consideration when planning treatment and rehabilitation after stroke. SN - 0002-0729 UR - https://www.unboundmedicine.com/medline/citation/14960430/Short__and_long_term_prognosis_for_very_old_stroke_patients__The_Copenhagen_Stroke_Study_ DB - PRIME DP - Unbound Medicine ER -