Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke

Arnold, M; Halpern, M; Meier, N; Fischer, Urs; Haefeli, T; Kappeler, L; Brekenfeld, C; Mattle, H P; Nedeltchev, K (2008). Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke. Journal of neurology, 255(10), pp. 1503-7. Heidelberg: D. Steinkopff-Verlag 10.1007/s00415-008-0949-9

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BACKGROUND : Comparisons between younger and older stroke patients including comorbidities are limited. METHODS : Prospective data of consecutive patients with first ever acute ischemic stroke were compared between younger (</= 45 years) and older patients (> 45 years). RESULTS : Among 1004 patients, 137 (14 %) were </= 45 years. Younger patients were more commonly female (57 % versus 34 %; p < 0.0001), had a lower frequency of diabetes (1 % versus 15 %; p < 0.0001), hypercholesterolemia (26 % versus 56 %; p < 0.0001), hypertension (19 % versus 65 %; p < 0.0001), coronary heart disease (14 % versus 40 %; p < 0.0001), and a lower mean Charlson co-morbidity index (CCI), (0.18 versus 0.84; p < 0.0001). Tobacco use was more prevalent in the young (39 % versus 26 %; P < 0.0001). Large artery disease (2 % versus 21 %; p < 0.0001), small artery disease (3 % versus 12 %; p = 0.0019) and atrial fibrillation (1 % versus 17 %; p = 0.001) were less common in young patients, while other etiologies (31 % versus 9 %; p < 0.0001), patent foramen ovale or atrial septal defect (44 % versus 26 %; p < 0.0001), and cervical artery dissection (26 % versus 7 %; p < 0.0001) were more frequent. A favorable outcome (mRS 0 or 1) was more common (57.4 % versus 46.9 %; p = 0.023), and mortality (5.1 % versus 12 %; p = 0.009) was lower in the young. After regression analysis, there was no independent association between age and outcome (p = 0.206) or mortality (p = 0.073). Baseline NIHSS score (p < 0.0001), diabetes (p = 0.041), and CCI (p = 0.002) independently predicted an unfavorable outcome. CONCLUSIONS : Younger patients were more likely to be female, had different risk factors and etiologies and fewer co-morbidities. There was no independent association between age and clinical outcome or mortality.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Arnold, Marcel; Meier, Niklaus; Fischer, Urs; Kappeler, Liliane; Brekenfeld, Caspar and Mattle, Heinrich

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0340-5354

ISBN:

18677634

Publisher:

D. Steinkopff-Verlag

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:01

Last Modified:

26 Jun 2018 13:17

Publisher DOI:

10.1007/s00415-008-0949-9

PubMed ID:

18677634

Web of Science ID:

000260877600008

BORIS DOI:

10.7892/boris.26689

URI:

https://boris.unibe.ch/id/eprint/26689 (FactScience: 85646)

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