Characteristics and Outcomes of Very Elderly Enrolled in a Prehospital Stroke Research Study

Stroke. 2016 Nov;47(11):2737-2741. doi: 10.1161/STROKEAHA.116.013318. Epub 2016 Sep 27.

Abstract

Background and purpose: Greater numbers of individuals aged ≥80 years enjoy a high quality of life, yet historically stroke trials have excluded this population. We aimed to describe a population of very elderly successfully enrolled into an acute stroke trial and compare their characteristics and outcomes with the younger cohort.

Methods: We analyzed consecutive patients enrolled <2 hours of symptom onset in a prehospital stroke treatment trial, the FAST-MAG clinical trial (Field Administration of Stroke Therapy-Magnesium). We gathered demographic, treatment, and outcome data for nonelderly (<80 years old), very elderly (≥80 years old), and extreme elderly (≥90 years old). We describe key differences in the population of elderly and the impact of their inclusion on the clinical trial.

Results: Of 1700 participants in FAST-MAG, there were 1210 nonelderly, 490 very elderly, and 60 extreme elderly subjects. Very elderly stroke patients successfully enrolled in a research study were more likely to be women, white, and have an ischemic mechanism rather than an intracerebral hemorrhage. Although the very elderly had generally poorer outcomes, 4 in 10 were functionally independent at 90 days.

Conclusions: Inclusion of the very elderly population in acute stroke clinical trials would both significantly increase study participation and generalizability of future acute stroke clinical trials.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00059332.

Keywords: aged; emergency medical services; hemorrhage; quality of life; stroke.

Publication types

  • Clinical Trial, Phase III
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications
  • Brain Ischemia / epidemiology*
  • Cerebral Hemorrhage / complications
  • Cerebral Hemorrhage / epidemiology*
  • Clinical Trials as Topic / standards
  • Clinical Trials as Topic / statistics & numerical data*
  • Female
  • Humans
  • Magnesium / therapeutic use
  • Male
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Patient Selection*
  • Risk Factors
  • Stroke / drug therapy
  • Stroke / epidemiology*
  • Stroke / etiology

Substances

  • Magnesium

Associated data

  • ClinicalTrials.gov/NCT00059332