Title : Stroke in very old patinets
Introduction: Presently, there is limited information on stroke care in the very old (80 years and older).
Aim: To evaluate vascular risk factors, stroke subtypes and clinical outcomes in very old patients admitted at our hospital with acute stroke.
Methods: We included in this study 504 stroke patients admitted to the Neurovascular Service at the University Hospital Center “Mother Teresa”, Tirana, Albania from February 2011 to December 2014.We assess if there were any significant differences between patients under 80 years old compared with older patients (80 years or older), with regard to vascular risk factors, stroke type and clinical outcome.
Results: Of 504patients, 378patients were less than 80 years, 126 were 80 years old and older. Younger patients were more likely to have diabetes (30, 6% versus 16, 2%, p<0,001). Older patients were more likely to have ischemic heart disease (38% versus 30, 1% p=0, 02), or atrial fibrillation (34, 5% versus 15, 2%, p<0,001).
Older patients were more likely to have Total Anterior Circulation Infarcts (TACI) strokes (17, 6% versus 11, 1%, p<0,009) or Partial Anterior Circulation Infarct strokes (PACI) (30, 1% versus 23, 5%, p=0, 04) Outcome data, which was available for 91% patients, showed that older patients stayed longer in hospital (median length of stay 23 days versus 18 days, (p=0,008) and had a higher inpatient mortality 14% versus 3, 7%, (p<0,001).
Conclusion: Very elderly patients have a different risk factor profile, have more anterior circulation infarcts and have a worse prognosis-with increased mortality and increased length of stay in hospital. Aging of poulation is a reality in the majority of countries all over the world. In our study patients with stroke over 80 had higher fatality and needed longer stay in the hospitals or in the neurocritical care. On the other hand the majority of them needed assistance after diacharge from the hospital, and were not able to live indipendently in their own homes. So, there is an increasing demand on healthcare system, Strategies need to be implemented to face the problem.