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Characteristics and Outcomes of Very Elderly Enrolled in a Prehospital Stroke Research Study
Nerses Sanossian1, Kathleen C Apibunyopas2, David S Liebeskind2
1From the Department of Neurology, Roxanna Todd Hodges Comprehensive Stroke Clinic (N.S., K.C.A., A.M.B.), and Department of Emergency Medicine (M.E.), University of Southern California, Los Angeles; Department of Neurology, Stroke Center (D.S.L., S. Starkman, J.L.S.) and Neurovascular Imaging Core Laboratory (D.S.L.) and School of Public Health (S. Stratton), University of California, Los Angeles; National Institutes of Neurological Disorders and Stroke, Bethesda, MD (R.C.); Department of Emergency Medicine, Torrance Memorial Medical Center, Torrance, CA (F.P.); Department of Neurology, Stanford University, CA (S.H.). sanossia@yahoo.com.
Background And Purpose:
Greater numbers of individuals aged ≥80 years enjoy a high quality of life, yet historically stroke trials have excluded this population. We aimed to describe a population of very elderly successfully enrolled into an acute stroke trial and compare their characteristics and outcomes with the younger cohort.
Methods:
We analyzed consecutive patients enrolled <2 hours of symptom onset in a prehospital stroke treatment trial, the FAST-MAG clinical trial (Field Administration of Stroke Therapy-Magnesium). We gathered demographic, treatment, and outcome data for nonelderly (<80 years old), very elderly (≥80 years old), and extreme elderly (≥90 years old). We describe key differences in the population of elderly and the impact of their inclusion on the clinical trial.
Results:
Of 1700 participants in FAST-MAG, there were 1210 nonelderly, 490 very elderly, and 60 extreme elderly subjects. Very elderly stroke patients successfully enrolled in a research study were more likely to be women, white, and have an ischemic mechanism rather than an intracerebral hemorrhage. Although the very elderly had generally poorer outcomes, 4 in 10 were functionally independent at 90 days.
Conclusions:
Inclusion of the very elderly population in acute stroke clinical trials would both significantly increase study participation and generalizability of future acute stroke clinical trials.
Clinical Trial Registration:
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.
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