Age-Related Treatment and Outcomes in Stroke Examined

Older stroke victims more likely to die in hospital, but age-related therapy gaps improving
By Jeff Muise
HealthDay Reporter

TUESDAY, Feb. 9 (HealthDay News) -- Older people who suffer ischemic stroke are more likely to die in the hospital than younger stroke victims, though disparities in care by age group have been reduced or eliminated in recent years, according to a study published online Feb. 8 in Circulation.

Gregg C. Fonarow, M.D., of the University of California in Los Angeles, and colleagues analyzed the clinical factors, hospital performance measures, and outcomes for 502,036 ischemic stroke patients at 1,256 hospitals that participated in the Get With the Guidelines -- Stroke program in 2003 to 2009. The researchers examined the relationships between patient age, clinical characteristics, hospital performance measures (such as timely thrombolysis and antithrombotic medication), treatment trends, and early clinical outcomes.

The researchers found that older patients were more likely to die in the hospital than younger patients, with the adjusted odds ratio for death increasing by 1.27 for each 10-year age increase. Also, older patients were less likely to be discharged home (odds ratio, 0.69). The researchers reported that while there were modest age-related differences in some hospital performance measures early on, these improved from 2003 to 2009 for each age group, and were substantially narrowed or eliminated.

"Older patients with ischemic stroke differ in clinical characteristics and experience higher in-hospital mortality than younger patients. Performance measure-based treatment rates improved substantially over time for ischemic stroke patients in all age groups, resulting in smaller age-related treatment gaps," the authors write.

Several study authors reported financial and advisory relationships with pharmaceutical or medical device companies. Two study authors are employed by the University of California in Los Angeles, which holds a patent on retriever devices for stroke.

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