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Clinical outcomes of cerebral infarction in nonagenarians compared among four age groups

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Abstract

Background

Average female life expectancy in Japan is approximately 90 years. Occasionally, we encounter stroke patients older than 90 years.

Aims

To determine the clinical features and outcomes associated with cerebral infarction in patients aged ≥ 90 years.

Methods

We examined 289 consecutive patients (163 males, 129 females; mean age 77.5 years) diagnosed with cerebral infarction. We divided them into four groups according to age in years: middle (< 65), pre-old (65–74), old (75–89), and super old (≥ 90). We divided the super old group into mild symptoms (NIHSS ≤ 5) and severe symptoms (NIHSS > 5) and examined outcomes.

Results

Statistically significant associations were observed between female sex, cardiogenic infarction, and high complication rates and super old age. NIHSS and mRS scores at 30-day post-stroke were higher in the super old group. In some cases, complications led to poor prognoses. Eighty-seven percent of patients with mild symptoms (NIHSS ≤ 5) recovered to mRS 0–2 similar to the younger age group. None of the patients with severe symptoms (NIHSS > 5) recovered to mRS 0–2.

Discussion

We investigated the clinical outcomes following cerebral infarction in patients aged 90 years or older and found that mild symptoms were consistently associated with good prognoses, regardless of patients’ age.

Conclusions

Patients in the super old group had more severe symptoms and poorer outcomes than younger age groups. However, patients with mild symptoms tended to have better prognoses and returned to daily life similar to the younger age group.

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Acknowledgments

This study was supported by research funds provided to promote hospital functions of the Japan Organization of Occupational Health and Safety.

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Authors and Affiliations

  1. Department of Neurosurgery, Kyushu Rosai Hospital, Moji Medical Center, 3–1 Higashiminatomachi, Moji-ku, Kitakyushu City, Fukuoka, 801–8502, Japan

    Takeru Umemura & Hiroshi Miyachi

  2. Department of Rehabilitation Medicine, Kyushu Rosai Hospital, Moji Medical Center, Kitakyushu, Japan

    Kenji Hachisuka

  3. Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan

    Shigeru Nishizawa & Junkoh Yamamoto

Authors
  1. Takeru Umemura
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  2. Kenji Hachisuka
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  3. Hiroshi Miyachi
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  4. Shigeru Nishizawa
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  5. Junkoh Yamamoto
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Corresponding author

Correspondence to Takeru Umemura.

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Umemura, T., Hachisuka, K., Miyachi, H. et al. Clinical outcomes of cerebral infarction in nonagenarians compared among four age groups. Neurol Sci 41, 2471–2476 (2020). https://doi.org/10.1007/s10072-020-04348-y

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  • DOI: https://doi.org/10.1007/s10072-020-04348-y

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