Long-term outcomes of acute ischemic stroke in patients aged 80 years and older

Purpose: Short life expectancy influences decision-making when treating very old patients with acute ischemic stroke (AIS). We investigated mortality and survival duration in very old AIS patients (>= 80 years) who received hospital care. Patients and Methods: Mortality data were obtained from medical records, structured telephone inquiries, death certificates from the Korean National Statistical Office, and social security data 5 +/- 1.9 years after stroke onset. Age, gender, vascular risk factors, and functional outcomes from modified Rankin scales (MRS) at discharge were analyzed as predictors of mortality. Results: Among 134 patients, 92 (68.7%) died. On Kaplan-Meier analysis, duration of survival of patients aged 80 - 84 years was longer than those aged 85 - 89 or 90 - 94 (24 +/- 6.4, 8 +/- 7.3, 7 +/- 2.0 months, respectively, p = 0.002). Duration of survival of patients discharged in a state of MRS 0 - I was longer than the remaining groups at 47 +/- 4.8 months (p < 0.001). In Cox proportional hazard analysis, age and MRS at discharge were independent predictors of mortality. Conclusion: Long-term outcomes of very old patients with AIS are not uniformly grave, therefore predictors of mortality and estimated duration of survival should be considered during decision-making for treatment.