Predictive Clinical Factors of In-Hospital Mortality in Women Aged 85 Years or More with Acute Ischemic Stroke

Abstract

Plain Language SummaryAcute cerebrovascular disease also called stroke or brain attack is a very relevant medical condition because it may have devastating consequences in terms of disability, impaired cognition, need of prolonged rehabilitation and death. Acute stroke at older age has a great impact on the ability to live independently, and the number of elderly people affected by stroke is expected to increase due to demographic projections and the aging population in industrialized countries. There are important sex-related differences with regard to the characteristics of stroke, but there are a few studies focused on women in the oldest old age segment group. This study examined clinical risk factors for early death in a large cohort of 506 women aged 85 years or more suffering from an acute ischemic stroke, the data of which were collected from an ongoing 24-year hospital stroke database. The mean age of the patients was 88.6 years. Mortality during the patients’ stay in the hospital was high. A total of 103 patients died, with a mortality rate of 20.4%. Some variables were significant predictors of mortality, including sudden onset of symptoms, altered consciousness, and the development of neurological, cardiac, respiratory, and hemorrhagic complications during hospitalization. Lacunar infarction, which is a subtype of stroke causing small-sized infarcts, was associated with a favorable prognosis. Better knowledge of the clinical features of ischemic stroke in very old women is indispensable to establish an early diagnosis and prompt effective therapy to improve the prognosis and neurological recovery of these patients.