Predictors of ischemic stroke in elderly patients in Vietnam
Research Topic: Vietnamese Medical Research
We investigated independent predictors of acute ischemic stroke (AIS) in older elderly (>75 years) patients in comparison with those of the elderly (from 60-75 years) in Vietnam. Data are for 308 consecutive AIS patients aged ≥ 60 years (138 aged >75 years) admitted to the stroke unit of Phu Tho Hospital from (2014-2017). An assessment of symptoms was also carried out using the NIH Stroke Scale (NIHSS), symptoms, instrumental and laboratory parameters during hospitalization and complications of the underlying disease. The existing predictors of hospital death, trauma, and length of hospital stay were also taken into account. When evaluating the parameters, logistic regression was used. Risk profiles before and after age 75 were compared. Age is a proven, unmodifiable, universal predisposing risk factor for stroke. Poor outcomes were more frequent in the oldest (>75 years) compared to the younger patients (≤75 years). NIHSS score and clinical parameters of AIS severity, including need for oxygen, indwelling catheter, or nasogastric tube), disability incidents, and medical complications predicted most of the outcomes in both age groups. After age 75, AIS etiology and primary clinical signs and symptoms were additional independent determinants for most outcomes, along with age, sex, and pre-stroke functional and health statusThe key factors were mechanical ventilation and pneumonia, and pre-stroke signs during the first three days in the hospital for AIS in the oldest- old (>75 years).; in patients ≤75 years, atrial fibrillation was associated with poor outcomes and death at discharge.