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KMID : 0311120080490030400
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Yonsei Medical Journal
2008 Volume.49 No. 3 p.400 ~ p.404
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Long-Term Outcomes of Acute Ischemic Stroke in Patients Aged 80 Years and Older
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Minn Yang-Ki
Chu Min-Kyung
Lee Ju-Hun
Cho Soo-Jin
Oh Mee-Sun
Kwon Ki-Han
Hwang Sung-Hee
Lee Byung-Chul
Kim Seon-Gyung
Kim Jin-Hyuck
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Abstract
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Purpose: Short life expectancy influences decision-making when treating very old patients with acute ischemic stroke (AIS). We investigated mortality and survival duration in very old AIS patients (≥ 80 years) who received hospital care.
Patients and Methods: Mortality data were obtained from medical records, structured telephone inquiries, death certificates from the Korean National Statistical Office, and social security data 5 ± 1.9 years after stroke onset. Age, gender, vascular risk factors, and functional outcomes from modified Rankin scales (MRS) at discharge were analyzed as predictors of mortality.
Results: Among 134 patients, 92 (68.7%) died. On Kaplan-Meier analysis, duration of survival of patients aged 80-84 years was longer than those aged 85-89 or 90-94 (24 ± 6.4, 8 ± 7.3, 7 ± 2.0 months, respectively, p = 0.002). Duration of survival of patients discharged in a state of MRS 0-1 was longer than the remaining groups at 47 ± 4.8 months (p < 0.001). In Cox proportional hazard analysis, age and MRS at discharge were independent predictors of mortality.
Conclusion: Long-term outcomes of very old patients with AIS are not uniformly grave, therefore predictors of mortality and estimated duration of survival should be considered during decision-making for treatment.
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KEYWORD
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Aging, ischemic stroke, prognosis, mortality
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