Acute stroke in very old patients: Risk factors, subtypes and predictors of in-hospital mortality.

BACKGROUND: The death rates from stroke Increase exponentially with age and are higher in men. Factors associated with increased mortality among stroke patients have been extensively studied in young patients but not in older patients, who constitute a significant proportion of stroke victims.

OBJECTIVE: To describe the risk factors, stroke subtypes. time interval from the onset of signs and symptoms to hospital admission, in-hospital worsening of condition and mortality of acute stroke events occurring in individuals aged 80 years old and above

METHODOLOGY. This is a prospective analytical study of a sub-set of population, the very old, included in an ongoing longitudinal hospital based study of acute stroke. (Stroke Data Bank- Research Biotechnology Division of St. Lukes Medical Center).

RESULTS. A total of 60 (7 percent) out of 855 strokes admitted to St. Lukes Medical Center from January 1, 1999 to June 30, 2000 occurred in very old patients with a mean age of 84.5 +/- 4 years. Using the conditional logistic regression (multivariate) analysis, the stroke subtype cardioembolic is associated with worsening of condition in the hospital (P0.03) but was not a determinant of in-hospital mortality. Likewise, risk factors such as age, gender, hypertension, diabetes mellitus, heart disease, hypercholesterolemia, and smoking were not associated with worsening neither with in-hospital mortality.

CONCLUSION: In general, risk factors, namely age, gender, hypertension, heart disease, diabetes mellitus, hypercholesterolemia, smoking and time interval from onset of signs and symptoms to hospital admission were found to be not significantly correlated with in-hospital deterioration and mortality. Cardioembolic subtype of stroke however showed a correlation with in-hospital deterioration.