Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Ann Palliat Med

Publication type: Original Contributions

IF(IF): 2.59

PMID: 35272470 Link To Pubmed Full text Download

Stroke is a major cause of disability and mortality all over the world. China bears the biggest stroke burden in the world, and the burden is expected to increase further as a result of population aging. Over 80% of strokes occur in elderly individuals, and the prognosis of a patient after stroke is highly impacted by age. Despite the ongoing growing elderly population in China, limited data were available on clinical characteristics and prognosis in elderly patients. A previous study conducted about ten years ago indicated that compared with the Caucasian population, elderly stroke patients in China have a worse clinical prognosis, especially in terms of death and recurrence rates. Besides, significant advances have recently been achieved in the acute management and secondary prevention of acute ischemic stroke, including the development of dual antiplatelet therapy and improved guidelines for thrombolysis and thrombectomy. However, previous randomized clinical trials (RCTs) on acute stroke therapy frequently excluded the very elderly adults, contributing to the evidence base for the very elderly is inadequate. Therefore, limited data were available on the current clinical characteristic, medication and prognosis of the very elderly population, especially in China. In the study, based on the Third China National Stroke Registry (CNSR-III), we aim to evaluate the clinical characteristics, etiology classification, medication persistence, and prognosis of very elderly patients with ischemic stroke or transient ischemic attack (TIA) from 2015-2018 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.