Document Detail


Stroke in the very old: incidence, risk factors, clinical features, outcomes and access to resources--a 22-year population-based study.
MedLine Citation:
PMID:  19955734     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: For several years, the burden of stroke in very old patients has been increasing in western countries. Nevertheless, we have little information about this new challenge in individuals >or=80. METHODS: We ascertained all first-ever strokes in the population of Dijon, France (150,000 inhabitants), from 1985 to 2006. The incidence of stroke, risk factors, clinical presentation, resource mobilization and 1-month outcome were evaluated in individuals >or=80 and compared to the data obtained in younger patients. RESULTS: We collected 1,410 first-ever strokes in people >or=80 years (39%) versus 2,130 in those <80 years. The incidence was 997/100,000, and 68/100,000, respectively. Over the 22 years, the incidence of stroke in individuals >or=80 years rose significantly. A lower prevalence of diabetes, hypercholesterolemia and alcohol intake, as well as a higher prevalence of hypertension, atrial fibrillation, previous myocardial infarction and use of prestroke antiplatelet agents were noted in patients >or=80 years. The clinical presentation was severer and the 1-month outcome in terms of case fatality and handicap was worse, despite improvements observed over time. Finally, in patients >or=80 years, the use of CT scan, MRI, cervical Doppler, angiography and carotid surgery were significantly lower than for younger patients. Length of stay >30 days was more frequent, and discharge to prestroke residence was less common. However, all these improved between the first and the last study periods. CONCLUSIONS: Our findings have important implications not only for clinical management but also for initiating preventive strategies and health policy.
Authors:
Yannick B?jot; Olivier Rouaud; Agn?s Jacquin; Guy-Victor Osseby; J?r?me Durier; Patrick Manckoundia; Pierre Pfitzenmeyer; Thibault Moreau; Maurice Giroud
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-12-01
Journal Detail:
Title:  Cerebrovascular diseases (Basel, Switzerland)     Volume:  29     ISSN:  1421-9786     ISO Abbreviation:  Cerebrovasc. Dis.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-21     Completed Date:  2010-03-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9100851     Medline TA:  Cerebrovasc Dis     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  111-21     Citation Subset:  IM    
Copyright Information:
(c) 2009 S. Karger AG, Basel.
Affiliation:
Stroke Registry of Dijon (INSERM et Institut de Veille Sanitaire), EA4184, University Hospital and Faculty of Medicine and Department of Neurology, Dijon, France. ybejot @ yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged, 80 and over
Disability Evaluation
Disease Progression
Female
France / epidemiology
Health Resources* / utilization
Health Services Accessibility* / statistics & numerical data
Health Services for the Aged* / utilization
Humans
Incidence
Kaplan-Meiers Estimate
Length of Stay
Logistic Models
Male
Odds Ratio
Population Surveillance
Recovery of Function
Registries
Risk Assessment
Risk Factors
Severity of Illness Index
Stroke / diagnosis,  etiology,  mortality,  physiopathology,  therapy*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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