| Stroke in the very old: incidence, risk factors, clinical features, outcomes and access to resources--a 22-year population-based study. | |
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MedLine Citation:
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PMID: 19955734 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Comparative Study; Journal Article Date: 2009-12-01 |
Journal Detail:
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Title: Cerebrovascular diseases (Basel, Switzerland) Volume: 29 ISSN: 1421-9786 ISO Abbreviation: Cerebrovasc. Dis. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-21 Completed Date: 2010-03-25 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9100851 Medline TA: Cerebrovasc Dis Country: Switzerland |
Other Details:
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Languages: eng Pagination: 111-21 Citation Subset: IM |
Copyright Information:
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(c) 2009 S. Karger AG, Basel. |
Affiliation:
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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:
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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 |
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