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Journal of the Korean Neurological Association 2013;31(4): 234-238.
80세 이상 고령 환자에서 발생한 뇌경색의 임상과 영상 특징: 단일기관연구
임은예, 왕민정 박형은 최유진 이지연 김우준 조아현
가톨릭대학교 의과대학 여의도성모병원 신경과
Clinical and Radiological Characteristics of Ischemic Stroke in the 80 Year-Old or Older: A Single Center Study
Eun Ye Lim
Department of Neurology, Yeouido St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
Abstract
Background: The risk profiles and stroke presentations may differ between elderly stroke patients and their younger counterparts. The most appropriate stroke-management regime for a better outcome can only be achieved with knowledge of the characteristics of elderly stroke patients. This study compared the clinical and radiological characteristics of elderly (≥80 years) ischemic stroke patients with those aged <80 years.
Methods: Consecutive acute ischemic stroke patients were enrolled. The following parameters were obtained for each patient: clinical variables [i.e., risk factors, initial National Institutes of Health Stroke Scale (NIHSS) score, mode of onset, in-hospital complications, and modified Rankin scale (mRS) score at 3?months], radiological variables, and clinicoradiological discrepancies.
Results: Of the 436 enrolled patients, 60 (13.8%) were elderly. The proportion of men was lower among the elderly than among those patients aged >80?years (40.0% vs. 63.3%; p=0.001), while their initial NIHSS score was higher (median, 4 vs. 3; p=0.033). Furthermore, an unclear stroke onset (46.4% vs. 32.8%; p=0.049) and clinicoradiological discrepancies (13.8% vs. 5.7%; p=0.044) were more common among the elderly. The proportions of subjects with stroke of undetermined cause (30.0% vs. 18.0%; p=0.019) and multiple circulation infarctions (23.3% vs. 12.6%, p=0.030) were higher among the elderly. A favorable outcome (mRS score of 0 or 1) was more common in the younger stroke patients (57.5% vs. 25.9%, p<0.0001). Multivariate analysis revealed that younger age, male gender, and initial stroke severity were significantly associated with a favorable outcome.
Conclusions: These results indicate that stroke presentation in the elderly differs from that of their younger counterparts in terms of clinical and radiological variables.Key Words: Ischemic stroke, Elderly, Clinical outcome, Diffusion-weighted imaging