Stroke in patients aged over 75 years: outcome and predictors.

Abstract

The outcome and predictors of stroke rehabilitation were studied prospectively in 96 patients (mean age 81.3 +/- 5.4 years) admitted to geriatric wards from a well-defined area over one year. Of these, 32 (33%) died (median survival 11 days), 52 (54%) returned home (median hospital stay 69 days) and 12 (13%) required long-term care (median hospital stay 164 days). Deaths and discharges showed a bimodal pattern; nearly 40% of the patients died or were discharged within 2 weeks of admission. Early death correlated with level of consciousness (P = 0.02), neurological deficit (P = 0.01) and prestroke Barthel scores (P = 0.04) on admission. Patients with right- rather than left-sided hemiparesis (P = 0.02), good motor power (P = 0.002) and without sensory deficit/inattention (P = 0.002) were discharged early. Discharge home was adversely affected by poor awareness of deficit (P = 0.02), hemianopia (P = 0.03) and incontinence (P = 0.02) assessed at 2 weeks. Stroke survivors with Barthel score < 6 and Mental Test Score < 4 at 2 weeks after stroke required long-term care.