Stroke: elderly: previous disability or increasing stroke severity increased the risk of disability at 3 months

Clinical bottom line (level 1b)

  1. Patients aged 80 or more with a first stroke were more likely to be disabled at 3 months with
    • urinary incontinence
    • paralysis
    • prestroke institutionalisation
    • swallowing problems
di Carlo et al: Stroke 1999; 30 : 2313-2319
Expires December 2003

The study

Inception cohort study with objective outcomes, adjusted for confounding factors, not validated in an independent set of patients.

Setting: 22 acute hospitals, 7 European countries

1358 patients (aged 80 to 102; mean 85, 67% female) with a first stroke

Excluded if
  • aged < 80


Factors studied:
  • age, sex, cardiovascular risk factors, disability



    Logisitic regression analysis used to adjust for confounding factors.

    80% followed for 3 months
    Outcomes studied:

    The evidence


    • Disability at 3 months was associated with
      • prestroke institutionalisation: OR: 2.33 (95% CI: 1.22 to 4.45)
      • paralysis: OR: 3.71 (95% CI: 2.37 to 5.81)
      • swallowing problems: OR: 1.91 (95% CI: 1.09 to 3.34)
      • urinary incontinence: OR: 3.94 (95% CI: 2.48 to 6.24)

    Comments

    1. The percentage of elderly patients with disability at 3 months was not reported.
    2. Patients aged 80 or more were more likely to present in confusion or a coma, and more likely to have more severe strokes.
    3. Older patients received less occupational therapy and speech therapy than patients aged < 80.

    Citation

    1. di Carlo A, Lamassa M, Pracucci G, et al: stroke in the very old: clinical presentation and determinants of 3-month functional outcome: a European perspective. Stroke 1999; 30 : 2313-2319
    Search Terms: ?
    Contributor: Chris Ball, December 2001
    Reviewer:

    Clinical Question.
    Patient ged 80 or more
    Intervention or Exposure first stroke
    Outcome disability
    		•