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80 岁以上和 80 岁以下患者的缺血性脑卒中。

Ischemic stroke in patients older and younger than 80 years.

机构信息

Department of Neurology, Haukeland University Hospital, Bergen, Norway.

出版信息

Acta Neurol Scand. 2014 Jun;129(6):399-404. doi: 10.1111/ane.12199. Epub 2013 Nov 21.

Abstract

OBJECTIVES

To compare short-term outcome and long-term mortality in old and younger patients with ischemic stroke. We hypothesized that short-term outcomes in patients≥80 and <80 years with no neurological worsening are similar.

METHODS

The National Institute of Health Stroke Scale (NIHSS) was used to assess stroke severity. Short-term outcome was determined by the NIHSS score 7 days after stroke onset. Neurological worsening was defined as NIHSS score worsening >3 points. Risk factors, prior diseases, complications, and long-term mortality were registered.

RESULTS

The study includes 592 patients≥80 years and 1275 patients<80 years. High NIHSS score on admission and day 7, neurological worsening, and complications were significantly more frequent among patients≥80 years. In patients with no neurological worsening, improvement in NIHSS score on day 7 was not associated with age≥80 years (P=0.75). Long-term mortality was associated with the number of risk factors in both age groups (P<0.05).

CONCLUSION

Avoiding neurological worsening may have a large potential for reducing the difference in short-term outcome between old and young stroke patients by preventing treatable complications including pneumonia. Risk factor burden is important for long-term survival in both stroke patients≥80 years and <80 years.

摘要

目的

比较老年和年轻缺血性脑卒中患者的短期预后和长期死亡率。我们假设,在无神经功能恶化的情况下,≥80 岁和<80 岁的患者的短期预后相似。

方法

采用国立卫生研究院卒中量表(NIHSS)评估卒中严重程度。短期预后通过卒中发病后 7 天的 NIHSS 评分来确定。神经功能恶化定义为 NIHSS 评分恶化>3 分。记录了危险因素、既往疾病、并发症和长期死亡率。

结果

本研究纳入了 592 例≥80 岁和 1275 例<80 岁的患者。入院时和第 7 天 NIHSS 评分较高、神经功能恶化和并发症在≥80 岁的患者中更为常见。在无神经功能恶化的患者中,第 7 天 NIHSS 评分的改善与年龄≥80 岁无关(P=0.75)。在两个年龄组中,长期死亡率与危险因素的数量相关(P<0.05)。

结论

避免神经功能恶化可能通过预防可治疗的并发症(包括肺炎)来降低老年和年轻脑卒中患者短期预后的差异,这具有很大的潜力。危险因素负担对≥80 岁和<80 岁的脑卒中患者的长期生存都很重要。

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