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Prognosis of elderly hospital patients with cerebral thrombosis
1Second Department of Medicine, University of Helsinki, University Central Hospital, Kuopio, Finland.
Insights
Age significantly impacts outcomes for patients with cerebral thrombosis. Older individuals face higher case-fatality rates and poorer long-term survival, with co-existing conditions having minimal effect in the elderly.
Area of Science:
- Neurology
- Epidemiology
- Geriatrics
Background:
- Cerebral thrombosis is a significant cause of morbidity and mortality.
- Understanding prognostic factors is crucial for patient management and resource allocation.
Purpose of the Study:
- To retrospectively analyze the outcomes and prognostic factors in a large cohort of patients hospitalized for cerebral thrombosis.
- To investigate the influence of age and comorbidities on case-fatality and long-term survival.
Main Methods:
- Retrospective survey of over 8000 patients hospitalized with cerebral thrombosis between 1970 and 1980.
- Analysis of case-fatality rates and cumulative survival rates across different age groups.
- Evaluation of the impact of coronary heart disease, hypertension, and other diseases on prognosis.
Main Results:
- Case-fatality rates increased substantially with age, ranging from 6% in those under 50 to 66% in those over 85.
- Cumulative survival rates at 1 and 5 years significantly decreased with advancing age.
- Coronary heart disease impacted prognosis in younger patients (<75 years), while hypertension did not significantly affect survival.
- In patients over 75, additional diseases like diabetes had no significant effect on outcomes, highlighting the severity of cerebral thrombosis itself.
Conclusions:
- Age is a primary determinant of prognosis in cerebral thrombosis.
- The inherent severity of cerebral thrombosis, particularly in older adults, outweighs the influence of comorbidities on survival.
- Further research into age-specific management strategies for cerebral thrombosis is warranted.
Abstract:
Over 8000 patients with cerebral thrombosis (ICD-8 number 433) hospitalised between 1970 and 1980 were surveyed retrospectively for outcome and additional diseases. The case-fatality rates and long-term prognosis of the patients were strongly affected by age, and the number of patients requiring permanent hospital care rose sharply with increasing age. The case-fatality rates in the different age groups were as follows: under 50 years 6%, 50-64 years 16%, 65-74 years 32%, 75-84 years 48% and over 85 years 66%. The cumulative survival rates at 1 and 5 years were as follows: under 50 years 54 and 46%, 50-64 years and 38%, 65-74 years 60 and 20% and over 75 years 45 and 10%. Clinical manifest coronary heart disease clearly affected the prognosis of patients under 75 years, but the impact diminished with rising age. Although hypertension led to an earlier onset of ischemic stroke, it did not significantly influence the survival prognosis. In patients over 75 years additional diseases, e.g. diabetes, had no significant effect on case-fatality or long-term prognosis underlining the malignant nature of cerebral thrombosis itself.