Stroke Characteristics in the Elderly: A Hospital-Based Study in Cameroon

Abstract

<b><i>Introduction:</i></b> Advanced age is an important nonmodifiable risk factor for stroke. Little data are available on stroke in older people in sub-Saharan Africa. This study aimed to determine the clinical features of stroke and identify the predictive factors for poor outcomes in this age group. <b><i>Methods:</i></b> A 4-month retrospective study was conducted using the Stroke Registry of Douala General Hospital. The main outcomes were mortality, poor functional recovery at 3 months (modified Rankin Scale score ≥3), and recurrence at 1 year. Factors associated with poor outcomes were determined using binary logistic regression. Survival was estimated using the Kaplan-Meier method. The significance threshold was set at <i>p</i> &lt; 0.05. <b><i>Results:</i></b> Elderly patients represented 38.6% of all stroke cases (<i>n</i> = 1,260). Male represented 48.6% of the old patients. The incidence of hypertension, diabetes, previous stroke, and cardiopathies was significantly higher in older patients (<i>p</i> &lt; 0.05). Ischemic stroke accounted for 73.1% of stroke types. Cardiopathies, GCS 8–12, GCS &lt;8, hemorrhagic stroke, NIHSS &gt;14, and Barthel index at 1 month were independently associated with mortality. Being divorced, a modified Rankin scale score ≥3 at 1 month, and a Barthel index ≤60 at 1 month were independently associated with poor functional recovery at 3 months. Old patients represented 50% of recurrent stroke cases. Age &gt;90 years (<i>p</i> &lt; 0.001) and NIHSS &lt;5 were independently associated to recurrence at 1 year. <b><i>Conclusion:</i></b> Approximately two out of five stroke cases were old. Cardiopathies, hemorrhagic stroke, and data related to stroke severity contribute to poor outcomes. A management approach that considers the particularities of this age group could contribute to improving the outcomes of these patients.