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Stroke outcome in those over 80: a multicenter cohort study across Canada
Gustavo Saposnik1, Robert Cote, Stephen Phillips
1South East Toronto Regional Stroke Center, Division of Neurology, Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada. saposnikg@smh.toronto.on.ca
Stroke
|June 17, 2008
Summary
Elderly patients over 80 experiencing acute ischemic stroke face higher fatality rates and longer hospital stays. Specialized stroke care access for seniors needs improvement to address these outcomes.
Area of Science:
- Geriatric Medicine
- Neurology
- Public Health
Background:
- Stroke prevalence is rising in elderly populations.
- Limited data exists on stroke burden in individuals aged 80 and above.
- This study addresses the clinical outcomes of acute ischemic stroke in this demographic.
Purpose of the Study:
- To evaluate clinical outcomes in Canadians over 80 hospitalized for acute ischemic stroke.
- To identify differences in outcomes compared to younger stroke patients.
- To inform healthcare strategies for elderly stroke care.
Main Methods:
- Multicenter cohort study using the Canadian Hospital Morbidity and Mortality Database (April 2003-March 2004).
- Analysis of 26,676 ischemic stroke admissions.
- Multivariable logistic regression to assess outcomes including fatality, ICU admission, and discharge disposition.
Main Results:
- Patients aged 80+ had a significantly higher case fatality rate at discharge (24.2%) compared to younger groups.
- Individuals over 80 were less likely to be admitted to the intensive care unit (ICU) and discharged to their previous residence.
- The median hospital stay was longer for patients over 80 (10 days vs. 7 days).
Conclusions:
- Patients aged 80 and over experience higher risk-adjusted fatality and prolonged hospitalization after ischemic stroke.
- Discharge to home is less common for the oldest stroke patients.
- Healthcare systems require strategies to ensure equitable access to specialized stroke care for the elderly.
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