Age Differences in Clinical Characteristics, Health care, and Outcomes after Ischemic Stroke in China

被引:24
作者
Deng, Ya-Xian [2 ]
Wang, Yi-Long [1 ]
Gao, Bao-Qin [2 ]
Wang, Chun-Xue [1 ]
Zhao, Xing-Quan [1 ]
Liu, Li-Ping [1 ]
Wang, An-Xin [1 ]
Zhou, Yong [1 ]
Liu, Gai-Fen [1 ]
Du, Wan-Liang [1 ]
Zhang, Ning [1 ]
Jing, Jing [1 ]
Meng, Xia [1 ]
Xu, Jie [1 ]
Wang, Lin-Yu [3 ]
Wang, Yong-Jun [1 ]
机构
[1] Capital Med Univ, Dept Neurol, Beijing Tiantan Hosp, Beijing 100050, Peoples R China
[2] Capital Med Univ, Dept Pediat, Beijing Tiantan Hosp, Beijing 100050, Peoples R China
[3] Zheng Zhou Univ, Affiliated Hosp 1, Dept Neurol, Zhengzhou, Henan, Peoples R China
关键词
China; Health care; Ischemic stroke; Outcome; Risk factor; CARDIOVASCULAR-DISEASES; PERFORMANCE-MEASURES; RISK-FACTORS; MANAGEMENT; DETERMINANTS; GUIDELINES; MORTALITY; ATTACK; CLASSIFICATION; MORBIDITY;
D O I
10.1111/j.1755-5949.2012.00378.x
中图分类号
Q189 [神经科学];
学科分类号
071006 ;
摘要
Background and purpose Little information is available on the effects of age on health care and outcomes of ischemic stroke (IS) in China. Our aim was to evaluated risk factors, health care, and outcomes among age groups including =45, 4665, 6679, and =80 similar to years and to find whether the outcome was affected by age and health care. Methods CNSR is a nationwide prospective registry for patients admitted with acute stroke and prospectively followed up 12-month outcomes. Demographics, socioeconomics, risk factors, health care, and outcomes were analyzed among age groups, and multivariate regression analysis was used to determine the association of outcome and age and health care. Results We identified 12,415 acute IS patients for analysis. Of 1179 (9.50%) were aged =80 similar to years. In terms of risk factors, cardiac diseases were significantly more frequent in patients =80 similar to years, behavioral risk factors were more common in younger patients, and hypertension, hyperlipidemia, and diabetes were more seen in 4679 patients. The use of health care varied among groups and was significantly lower in =80 similar to years especially in secondary prevention. The very old patients had the worst outcomes even after adjusting by prognostic factors; however, adjusting forward by health care, the extent of differences decreased. Conclusions In CNSR, differences in stroke clinic characteristics and health care were observed among various age groups, and the old patients, receiving lower levels of stroke care, had the worst outcomes. Knowledge of the age differences in ischemic stroke may be helpful to appropriately allocate the limited health resources and to improve stroke outcomes.
引用
收藏
页码:819 / 826
页数:8
相关论文
共 36 条
[1]   CLASSIFICATION OF SUBTYPE OF ACUTE ISCHEMIC STROKE - DEFINITIONS FOR USE IN A MULTICENTER CLINICAL-TRIAL [J].
ADAMS, HP ;
BENDIXEN, BH ;
KAPPELLE, LJ ;
BILLER, J ;
LOVE, BB ;
GORDON, DL ;
MARSH, EE ;
KASE, CS ;
WOLF, PA ;
BABIKIAN, VL ;
LICATAGEHR, EE ;
ALLEN, N ;
BRASS, LM ;
FAYAD, PB ;
PAVALKIS, FJ ;
WEINBERGER, JM ;
TUHRIM, S ;
RUDOLPH, SH ;
HOROWITZ, DR ;
BITTON, A ;
MOHR, JP ;
SACCO, RL ;
CLAVIJO, M ;
ROSENBAUM, DM ;
SPARR, SA ;
KATZ, P ;
KLONOWSKI, E ;
CULEBRAS, A ;
CAREY, G ;
MARTIR, NI ;
FICARRA, C ;
HOGAN, EL ;
CARTER, T ;
GURECKI, P ;
MUNTZ, BK ;
RAMIREZLASSEPAS, M ;
TULLOCH, JW ;
QUINONES, MR ;
MENDEZ, M ;
ZHANG, SM ;
ALA, T ;
JOHNSTON, KC ;
ANDERSON, DC ;
TARREL, RM ;
NANCE, MA ;
BUDLIE, SR ;
DIERICH, M ;
HELGASON, CM ;
HIER, DB ;
SHAPIRO, RA .
STROKE, 1993, 24 (01) :35-41
[2]  
[Anonymous], 1989, Stroke, V20, P1407
[3]   Age-dependent differences in demographics, risk factors, co-morbidity, etiology, management, and clinical outcome of acute ischemic stroke [J].
Arnold, Marcel ;
Halpern, Michael ;
Meier, Niklaus ;
Fischer, Urs ;
Haefeli, Tobias ;
Kappeler, Liliane ;
Brekenfeld, Caspar ;
Mattle, Heinrich P. ;
Nedeltchev, Krassen .
JOURNAL OF NEUROLOGY, 2008, 255 (10) :1503-1507
[4]   Characteristics of first ever ischemic stroke in the very elderly: Profile of vascular risk factors and clinical outcome [J].
Auriel, E. ;
Gur, A. Y. ;
Uralev, O. ;
Brill, S. ;
Shopin, L. ;
Karni, A. ;
Tsarfaty, S. Shenhar ;
Bornstein, N. M. .
CLINICAL NEUROLOGY AND NEUROSURGERY, 2011, 113 (08) :654-657
[5]   CLASSIFICATION AND NATURAL-HISTORY OF CLINICALLY IDENTIFIABLE SUBTYPES OF CEREBRAL INFARCTION [J].
BAMFORD, J ;
SANDERCOCK, P ;
DENNIS, M ;
BURN, J ;
WARLOW, C .
LANCET, 1991, 337 (8756) :1521-1526
[6]  
Beijing Neurologist Club, 2002, BNC PRACT GUID CER D
[7]   Older stroke patients in Europe: stroke care and determinants of outcome [J].
Bhalla, A ;
Grieve, R ;
Tilling, K ;
Rudd, AG ;
Wolfe, CDA .
AGE AND AGEING, 2004, 33 (06) :618-624
[8]   MEASUREMENTS OF ACUTE CEREBRAL INFARCTION - A CLINICAL EXAMINATION SCALE [J].
BROTT, T ;
ADAMS, HP ;
OLINGER, CP ;
MARLER, JR ;
BARSAN, WG ;
BILLER, J ;
SPILKER, J ;
HOLLERAN, R ;
EBERLE, R ;
HERTZBERG, V ;
RORICK, M ;
MOOMAW, CJ ;
WALKER, M .
STROKE, 1989, 20 (07) :864-870
[9]  
Chen Z, 1997, J Stroke Cerebrovasc Dis, V6, P361, DOI 10.1016/S1052-3057(97)80219-4
[10]   The Poor Outcome of Ischemic Stroke in Very Old People: A Cohort Study of Its Determinants [J].
Denti, Licia ;
Scoditti, Umberto ;
Tonelli, Claudio ;
Saccavini, Marsilio ;
Caminiti, Caterina ;
Valcavi, Rita ;
Benatti, Mario ;
Ceda, Gian Paolo .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2010, 58 (01) :12-17