Limited data are available about the prognosis of ischaemic stroke or transient ischaemic attack (TIA) in oldest-old patients, especially in China. We aimed to describe the clinical characteristics and prognosis of oldest-old patients with ischaemic stroke or TIA in China.
Patients with acute ischaemic stroke (AIS) or TIA were recruited between August 2015 and March 2018 in the Third China National Stroke Registry (CNSR-III). Clinical characteristics including demographic data, medical history, medication use and stroke aetiology, were obtained. The outcomes were one-year stroke recurrence, combined vascular events (stroke, myocardial infarction, and cardiovascular death), mortality, and poor functional outcome [modified Rankin scale (mRS) 3-6]. Oldest-old was defined as ≥80 years old. Clinical characteristics and prognosis were compared by different age groups (<65, 65-79, and ≥80 years). The association between age and prognosis was analysed using the multivariable Cox proportional hazards and logistic regression models.
A total of 15,166 patients with AIS or TIA were included in this study with 929 (6.13%) oldestold patients. Oldest-old patients had a higher likelihood of cardioembolic stroke or comorbid cardiac disease than other age groups. When compared with patients aged <65 years, oldest-old patients had higher risk of one-year stroke recurrence [adjusted hazard ratio (HR) 1.36; 95% confidence interval (CI): 1.06-1.73, P=0.014], combined vascular events [adjusted HR, 1.42; 95% CI, 1.13-1.79, P=0.003], mortality [adjusted odds ratio (OR), 4.25; 95% CI: 2.99-6.04, P<0.001] and poor functional outcome (adjusted OR, 4.25; 95% CI: 3.40-5.33, P<0.001) with P for trends <0.001 among age groups.
Oldest-old patients differed from younger patients regarding clinical characteristics, stroke aetiology, and secondary preventive medication persistence with a poor clinical prognosis in China. Current information on profile of the oldest-old stroke patients is crucial to develop specific secondary prevention and treatment strategies.