Outcomes for centenarians hospitalized with stroke linked to ability to walk at discharge

Key takeaways:

• Thirty-eight individuals aged 100 years and older were hospitalized for stroke.
• More than 75% of patients discharged to hospice after stroke were non-ambulatory at discharge and NPO during hospitalization.

BOSTON — For centenarians hospitalized with stroke, outcomes after treatment were affected by presenting stroke severity and ambulatory status at discharge, according to a poster at the American Academy of Neurology annual meeting.

“We do not know very much about this population, people who are over 100 years old,” Roxana Dragomir, MD, a resident physician in neurology at Florida Atlantic University Charles E. Schmidt College of Medicine, told Healio. “We do not know how often they come to the hospital, their risk factors and the measures used when they come in with stroke. It is a special population and it is increasing.”

Researchers sought to broaden the body of knowledge on cerebrovascular health in those aged 100 years or older by analyzing clinical characteristics, comorbidities and outcomes to better meet the needs of this growing and fragile population.

Dragomir and colleagues conducted a retrospective quality improvement analysis of 6,348 individuals from the Boca Raton Regional Hospital stroke database between 2007 and 2022 and identified 38 centenarians (76% women). Researchers evaluated ambulation before hospital admission and at discharge, as well as stroke treatment during hospitalization.

According to results, nearly half of the study group were independent walkers prior to admission, which dropped to almost 15% on discharge. The percentage of patients who walked with assistance or who were non-ambulatory at admission increased sharply upon discharge (10% to 35% with assistance; 0% to 30% non-ambulatory).

In addition, NIH Stroke Scale Scores (NIHSS) were lower on admission for the 39% of patients who were discharged to their homes (mean NIHSS = 2) compared with the 21% discharged to other health facilities (mean NIHSS = 6) and the 34% sent to hospice (mean NIHSS = 16).

Data also showed 11% of centenarians received IV thrombolytics or thrombectomy as stroke treatment, and 69% of those discharged to hospice were NPO during hospitalization and 77% were non-ambulatory at time of discharge.

“We need to know a little bit more about this population. We need to know what is going on once they have had a stroke,” Dragomir said. “At 100 years old, you become less ambulatory, your chances of being discharged to a facility rather than going home increase significantly.”