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Research Article
 
DOI:10.11909/j.issn.1671-5411.2019.11.008
Predictive clinical features of cardioembolic infarction in patients aged 85 years and older
Ana Maria Carbajo-Garcia,Jonatan Cortes,Adria Arboix,Joan Massons,Laura Diez,Enric Verges,Jordi Arboix-Alio,Luis Garcia-Eroles.Predictive clinical features of cardioembolic infarction in patients aged 85 years and olderJ Geriatr Cardiol 2019,16(11):793~799
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Authors:Ana Maria Carbajo-Garcia1;Jonatan Cortes1;Adria Arboix1;Joan Massons1;Laura Diez1;Enric Verges1;Jordi Arboix-Alio2;Luis Garcia-Eroles3

Author Affiliation:1.Cerebrovascular Division, Department of Neurology, Hospital Universitari del Sagrat Cor, Universitat de Barcelona, Barcelona, Catalonia, Spain;2.Department of Sports Sciences, Ramon Llull University, FPCEE Blanquerna, Barcelona, Catalonia, Spain;3.Director d’Organització i Sistemes d’Informació, Gerència Territorial Metropolitana Nord, Institut Català de la Salut, Barcelona, Catalonia, Spain

Foundation:

Abstract: Objective To assess predictive clinical factors of cardioembolic infarction in very old patients (85 years of age and older). Methods Prospective hospital-based stroke registry ("The Sagrat Cor Hospital of Barcelona Stroke Registry") is an acute-care teaching hospital in Barcelona, Catalonia, Spain. From 956 first-ever cardioembolic stroke patients included in the stroke registry over a 24-year period, 639 were younger than 85 years of age and 317 were 85 years or older (mean age 88.9 years). Demographics, clinical characteristics, risk factors and early outcome were compared. Predictors of cardioembolic infarction in the oldest age group were assessed by multivariate analyses. Results In a logistic regression model based on demographics, risk factors, clinical features and complications, female gender (odds ratio [OR] = 1.74, 95% confidence interval [CI]: 1.27–2.39), heart failure (OR = 2.27, 95% CI: 1.46–3.56), altered consciousness (OR = 1.76, 95% CI: 1.28–2.42), and infectious complications (OR = 2.01, 95% CI: 1.39–2.91) were predictors of cardioembolic stroke in the oldest age group. By contrast, heavy smoking, heart valve disease, hypertension, headache, early seizures, sensory deficit, and involvement of the posterior cerebral artery were independently associated with cardioembolic stroke in the younger group. Conclusions Identification of a differential clinical profile of cardioembolic stroke between patients aged 85 years or more and those younger than 85 years helps clinicians to the optimal management of ischemic infarction in the oldest segment of the population.

Keywords:

Cardioembolic stroke; Clinical features; Ischemic infarction; Stroke; Very old patients
Received:July 23, 2019        Accepted:November 19, 2019   Published Online:November 28, 2019
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