Department of Neurology, Barzilai Medical Center, Ashkelon, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Neuroepidemiology. 2012;39(1):57-62. doi: 10.1159/000339362. Epub 2012 Jul 8.
Epidemiological and clinical features of very elderly patients with stroke are still uncertain. Our aim was to study the patient characteristics and outcomes in the very elderly (aged ≥85 years) with a first-ever ischemic stroke in the National Acute Stroke Israeli Survey (NASIS) registry.
The NASIS registry is a nationwide prospective hospital-based study performed triennially (2004, 2007, 2010). Patients with ischemic stroke aged ≥85 years were compared with those 65-84 years old regarding their baseline characteristics, stroke severity, etiology of stroke and stroke outcomes. Logistic regression analyses were used to adjust for potential confounders. Stroke severity was determined according to the National Institute of Health Stroke Scale (NIHSS) score.
The proportion of very elderly (≥85 years) patients among the NASIS population increased from 18.3% in 2004 to 19.9% in 2007 and 24.5% in 2010 (p for trend = 0.005). The percentage of women was higher in patients aged ≥85 years (p < 0.0001). Atrial fibrillation, congestive heart disease and prior disability were significantly more common, while diabetes, current smoking and dyslipidemia were less frequent in the very elderly. The very elderly presented with more severe strokes: 36.3% of the ≥85-year-old patients had an NIHSS score ≥11 compared with 22.0% in the younger age group (p < 0.05).
There is an increasing proportion of very elderly subjects, mostly women, among first-ever ischemic stroke patients. Current information on age-specific aspects of stroke in the very elderly is crucial to set up successful prevention pathways and implementing well-organized stroke care for this population.
极高龄患者（≥85 岁）脑卒中的流行病学和临床特征仍不明确。本研究旨在探讨以色列全国急性脑卒中调查（NASIS）登记研究中首次发生缺血性脑卒中的极高龄患者的临床特征和预后。
NASIS 登记研究是一项全国性前瞻性医院为基础的研究，每三年开展一次（2004 年、2007 年和 2010 年）。本研究比较了≥85 岁和 65-84 岁的首次缺血性脑卒中患者的基线特征、脑卒中严重程度、脑卒中病因和脑卒中预后。采用 logistic 回归分析校正潜在混杂因素。脑卒中严重程度采用国立卫生研究院脑卒中量表（NIHSS）评分进行评估。
NASIS 登记研究人群中≥85 岁患者的比例从 2004 年的 18.3%增加到 2007 年的 19.9%和 2010 年的 24.5%（趋势性检验 P=0.005）。≥85 岁患者中女性比例更高（P<0.0001）。心房颤动、充血性心力衰竭和既往残疾在极高龄患者中更为常见，而糖尿病、当前吸烟和血脂异常在极高龄患者中较少见。极高龄患者脑卒中更严重：≥85 岁患者中有 36.3%的 NIHSS 评分≥11，而年轻患者中这一比例为 22.0%（P<0.05）。
首次发生缺血性脑卒中的患者中，极高龄患者（大多为女性）的比例逐渐增加。极高龄人群中与年龄相关的脑卒中具体信息对于制定成功的预防途径和为该人群提供组织良好的脑卒中护理至关重要。
