First-ever ischemic stroke in very old Asians: Clinical features, stroke subtypes, risk factors and outcome

Background: Prior studies have been conducted in very old white and black patients. However, stroke in very old Asians has not been studied. Methods: This study retrospectively reviewed the records of first-ever ischemic stroke patients admitted to the Chiayi Chang Gung Memorial Hospital in the middle part of Taiwan from January 2002 to December 2005. Clinical features, stroke subtypes, risk factors, acute ward mortality, length of acute ward stay, medical complications and medication for secondary stroke prevention at discharge were compared in 2 groups of first-ever ischemic stroke patients (one ≥80 and the other <80 years old). Results: Aged patients (≥80 years old) had a higher proportion of conscious impairment at admission, a longer acute ward stay, a higher incidence of total anterior circulation infarct and a lower frequency of lacunar infarct, more frequent atrial fibrillation and less frequent diabetes mellitus, hyperlipidemia and smoking habits, and a higher incidence of pneumonia, urinary tract infection and upper gastrointestinal bleeding. Conclusions: Understanding the risk factors and medical complications in very old stroke patients may help improve the stroke prevention strategy and the quality of stroke patient management.