Age Stratification and Stroke Severity in the Telestroke Network

Area of Science:

• Neurology
• Geriatrics
• Public Health

Background:

• Age is a primary risk factor for stroke, with 75% of strokes occurring in individuals 65 and older.
• Older adults (≥75 years) experience increased hospitalizations and mortality rates.
• Understanding age-specific risk factors is crucial for managing acute ischemic stroke (AIS).

Purpose of the Study:

• To investigate how age and clinical risk factors influence AIS severity in two distinct age groups: 65-74 years and ≥75 years.
• To identify specific risk factors associated with stroke severity in telestroke settings.
• To compare the impact of clinical factors on neurological function across different age categories.

Main Methods:

• Retrospective analysis of the PRISMA Health Stroke Registry (June 2010 - July 2016).
• Inclusion of baseline clinical and demographic data for AIS patients aged 65-74 and ≥75 years.
• Multivariate analysis to assess the association between risk factors and stroke severity.

Main Results:

• In patients aged 65-74, heart failure (OR=4.398) and elevated high-density lipoprotein (HDL) levels (OR=1.066) correlated with worsening neurological function.
• Obesity (OR=0.177) was associated with improved neurological function in the 65-74 age group.
• For patients ≥75 years, direct admission (OR=0.270) was linked to improved neurological function.

Conclusions:

• Heart failure and high HDL levels are significant predictors of poorer neurological outcomes in younger elderly stroke patients (65-74).
• Obesity in the 65-74 age group and direct hospital admission for patients ≥75 years are associated with better neurological recovery.
• Findings highlight the need for age-tailored stroke management strategies.