Key result
Hypertensive intracerebral hemorrhage in patients aged ≥80 years presented with more frequent thalamic hemorrhage (43% vs 28%, p=0.04) and ventricular extension compared to younger patients.
Why the study?
Does very advanced age (≥80 years) impact clinical characteristics and in-hospital mortality in hypertensive patients with intracerebral hemorrhage compared to younger patients?
Case-Control (n=224)
Does very advanced age (≥80 years) impact clinical characteristics and in-hospital mortality in hypertensive patients with intracerebral hemorrhage compared to younger patients?
Answers are grounded in this paper and cite their sources.
While hypertensive intracerebral hemorrhage in the very elderly presents with distinct clinical features like more frequent thalamic location and ventricular extension, these differences do not significantly impact early in-hospital mortality compared to younger patients.
BACKGROUND: The number of persons reaching the age 80 years and over is increasing in most populations. Literature focusing on hypertensive intracerebral hemorrhage (ICH) in this age group is lacking. Therefore, we aimed to analyze the main clinical characteristics of ICH of the advanced old age, in the context of hypertension. METHODS: From 1999 to 2003 we studied 56 hypertensive very elderly patients presenting with ICH (50% women; age 80-99 years). As controls, 168 hypertensive gender-matched persons with ICH, aged <80 years, were randomly selected by a 3:1 factor for clinical comparisons. RESULTS: Compared with their younger counterparts, the very elderly patients had a trend for fewer cases of obesity (34 vs. 49%, p = 0.05) and diabetes mellitus (12 vs. 24%, p = 0.06), had lower systolic, diastolic and mean blood pressure measures (in all, p < 0.01) and more cases with hematoma extension into ventricles (p = 0.02). Thalamic hemorrhage was more frequent in the very elderly patients than in controls (43 vs. 28%, p = 0.04). In multivariate analysis, age, Glasgow coma scale score at hospital admission, ICH volume and infratentorial location were independent predictors of in-hospital mortality, in all persons combined. In the very elderly group exclusively, Glasgow coma scale score was the only factor independently associated with mortality. CONCLUSIONS: ICH occurring in hypertensive patients aged > or =80 years has several differences from that seen in younger people; however, these differences do not seem to impact on early outcome.
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Chiquete et al. (2007) conducted a case-control in Hypertensive intracerebral hemorrhage (n=224). Very elderly age (≥80 years) vs. Younger age (<80 years) was evaluated on Thalamic hemorrhage (p=0.04). Hypertensive intracerebral hemorrhage in patients aged ≥80 years presented with more frequent thalamic hemorrhage (43% vs 28%, p=0.04) and ventricular extension compared to younger patients.
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