Centenarians with Cerebrovascular Disease: 38 Patients from a Single Center. How much do we know? What can we improve? (P2-5.021)

Abstract

<h3>Objective:</h3> To better meet their needs and improve care, the authors analyzed the clinical characteristics, co-morbidities, and outcomes of centenarians with cerebrovascular disease. <h3>Background:</h3> There is a dearth of literature on cerebrovascular disease in the oldest old-a fragile population with distinctive characteristics and specific exigencies. <h3>Design/Methods:</h3> Retrospective QI analysis of de-identified data on 6,348 patients (2007–2022) from the Boca Raton Regional Hospital Get With The Guidelines-Stroke database. <h3>Results:</h3> Centenarians (n=38) comprised 0.6% of the patients; 76% were female. Prior to admission 53% ambulated independently, 16% with assistance, and 5% were not ambulatory. Comorbid conditions included the following: hypertension-87%; dysplipidemia-58%; atrial fibrillation/flutter-34%; previous stroke-26%; previous TIA-18%; CAD/MI-18%; diabetes-8%; and carotid stenosis-8%. Stroke subtypes were as follows: ischemic stroke-74%, TIA-21%; intraparenchymal hemorrhage-5%; and SAH-0%. Clinical characteristics on admission follow: NIHSS (mean=8, range 0–28); SBP (mean=162, range 110–199); DBP (mean=78, range 50–111); BMI (mean=23, range 15–27); LDL (mean=113, range 44–207); glucose (mean=115, range 72–84). Eleven percent of the ischemic stroke patients received either IV thrombolytics (n=2) or thrombectomy (n=1). Ambulation on discharge follows: 16% ambulated independently; 37% with assistance, and 34% were not ambulatory. Disposition on discharge follows: 39% went home (mean NIHSS on admission=2, range 0–7); 21% went to other healthcare facilities (mean NIHSS on admission=6, range 1–23); and 34% of the patients were discharged with hospice (mean NIHSS on presentation=16, range 4–28). Among patients discharged to hospice, 69% were NPO the entire admission and 77% were not ambulatory at discharge. <h3>Conclusions:</h3> Centenarians discharged home after being admitted for cerebrovascular disease had lower presenting NIHSS than those discharged to a healthcare facility or discharged with hospice. Missing data precludes comparisons, but the majority of centenarians discharged with hospice were NPO the entire admission and were unable to ambulate at discharge. <b>Disclosure:</b> Dr. Dragomir has nothing to disclose. Dr. Carranza-Renteria has nothing to disclose. Dr. Babici has nothing to disclose. Mrs. Miles-Kiple has nothing to disclose. Mrs. Kent has received publishing royalties from a publication relating to health care. The institution of Dr. Barratt has received research support from American Academy of Neurology. The institution of Dr. Barratt has received research support from ABPN. The institution of Dr. Barratt has received research support from (Evolution Research Group participated in Alzheimers Clinical trials--I don’t know the dollar amount).