Abstract Details

Title Elderly Patients with Intracerebral Hemorrhage Have Worse Outcomes Compared with Younger Patients Despite Similar Severity and Complication Rates

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P05 - (-)

Poster/Presentation
Number 243

Objective

Background BACKGROUND: In the US, the number of patients over the age of 80 years old is rising.

Design/Methods DESIGN/METHODS: From our prospectively-collected registry, we reviewed patients ?18 years old with primary spontaneous ICH from 1/2010-3/2012.

Results RESULTS: We identified 777 patients, of which 115 (15%) were ?80 years of age. Patients ?80 were more likely to be men (p<0.01) and white (p<0.01). There were no differences in the risk factors, htn, hyperlipidemia, diabetes or in complications (UTI, DVT, PE, pneumonia, other bleeding) between the groups. Patients ?80 were more likely to have CAD (p<0.05). Initial clinical severity as measured by the median GCS or NIHSS was similar and not significantly different. Amyloid angiopathy was more common among patients ?80 (p<0.01). There was no difference in ICH location or in the incidence of IVH between the two groups. Patients ?80 years were less likely to undergo EVD, hemicraniectomy, or hematoma evacuation (p<0.05). Those ?80 years were less likely to have a favorable mRS (0-2) at discharge (p<0.01) and 90 days (p<0.05) and more likely to be transferred to hospice care (p<0.01) and die by 90 days (p<0.05). In-hospital mortality was not different between the groups.

Conclusions CONCLUSIONS: Contrary to our expectation, elderly patients with ICH did not have more complications than younger patients. Initial severity as measured by NIHSS and GCS and lesion location were similar in both groups. Although they had less favorable outcomes, they also were less likely to undergo surgical intervention and more likely to be transferred to hospice care. Our results raise the question whether older patients have worse outcomes because of less aggressive intervention and treatment.

Authors/Disclosures
Waldo Guerrero, MD PRESENTER	Dr. Guerrero has nothing to disclose.
Kiran Thakur, MD, FAAN (Columbia University College of Physicians and Surgeons)	Dr. Thakur has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Delve Bio.
Claude Nguyen, MD (Current Neurology Solutions)	Dr. Nguyen has nothing to disclose.
Osman Mir, MD (Texas Stroke Institute)	No disclosure on file
Sean I. Savitz, MD	Dr. Savitz has nothing to disclose.

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