Functional recovery after ischemic stroke--a matter of age: data from the Austrian Stroke Unit Registry

Neurology. 2012 Jan 24;78(4):279-85. doi: 10.1212/WNL.0b013e31824367ab. Epub 2012 Jan 11.


Objective: To analyze the association between patient age and good functional outcome after ischemic stroke with special focus on young patients who were numerically underrepresented in previous evaluations.

Methods: Of 43,163 ischemic stroke patients prospectively enrolled in the Austrian Stroke Unit Registry, 6,084 (14.1%) were ≤55 years old. Functional outcome was available in a representative subsample of 14,256 patients free of prestroke disability, 2,223 of whom were 55 years or younger. Herein we analyzed the effects of age on good functional outcome 3 months after stroke (modified Rankin Scale score ≤2).

Results: Good outcome was achieved in 88.2% (unadjusted probability) of young stroke patients (≤55 years). In multivariable analysis, age emerged as a significant predictor of outcome independent of stroke severity, etiology, performance of thrombolysis, sex, risk factors, and stroke complications. When the age stratum 56-65 years was used as a reference, odds ratios (95% confidence interval [95% CI]) of good outcome were 3.4 (1.9-6.4), 2.2 (1.6-3.2), and 1.5 (1.2-1.9) for patients aged 18-35, 36-45, and 46-55 years and 0.70 (0.60-0.81), 0.32 (0.28-0.37), and 0.18 (0.14-0.22) for those aged 66-75, 76-85, and >85 years (p < 0.001). In absolute terms, the regression-adjusted probability of good outcome was highest in the age group 18-35 years and gradually declined by 3.1%-4.2% per decade until age 75 with a steep drop thereafter. Findings applied equally to sexes and patients with and without IV thrombolysis or diabetes.

Conclusions: Age emerged as a highly significant inverse predictor of good functional outcome after ischemic stroke independent of stroke severity, characteristics, and complications with the age-outcome association exhibiting a nonlinear scale and extending to young stroke patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging*
  • Austria
  • Brain Ischemia / complications*
  • Confidence Intervals
  • Data Interpretation, Statistical
  • Diabetic Angiopathies / epidemiology
  • Diabetic Angiopathies / therapy
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Odds Ratio
  • Prospective Studies
  • Recovery of Function*
  • Registries
  • Risk Factors
  • Sex Factors
  • Stroke / epidemiology
  • Stroke / etiology
  • Stroke / therapy*
  • Thrombolytic Therapy
  • Treatment Outcome
  • Young Adult