TORONTO, Ont. July 14, 2008

Stroke in aging population to levy heavy demands on health-care system. Canada’s fast growing age group more likely to die from stroke, stay longer in hospital and less likely to be discharged home, Canadians 80 or older are more likely to die from stroke, stay longer in hospital and are less likely to be discharged home in a growing trend that researchers believe will have a domino effect on the health-care system, according to new research led by a St. Michael’s Hospital neurologist.
 
“Globally, as our population ages and we approach what has been dubbed the stroke ‘silver tsunami,’ we can expect to see an increase in the number of patients suffering from stroke,” said lead researcher Dr. Gustavo Saposnik of the Keenan Research Center in the Li Ka Shing Knowledge Institute of St. Michael’s Hospital. “Our study’s findings suggest we can anticipate that the impact of aging on stroke will cause longer hospital stays, more disabled stroke survivors, increase the demand for acute and long-term care beds and the need for more complex care. This study is a first step in understanding stroke outcomes in the elderly and the burden and challenges faced by the health-care system.”
 
Saposnik and colleagues from the Stroke Outcome Research Canada (SORCan) Working group analyzed 26,676 patients with an ischemic stroke admitted to 606 hospitals across Canada from April 1, 2003 to March 31, 2004. Researchers found that 38 per cent of hospitalized patients with an ischemic stroke were 80 or older. What’s more, these individuals had a higher fatality rate (seven days after being admitted and at discharge), a longer hospital stay, were less likely to be admitted to the ICU and discharged to their pre-stroke residence. In their analysis, researchers also found a link between fatality and socioeconomic factors, admission to a non-academic institution and gender.
 
“Women had a longer length of stay in hospital and were more likely to be discharged to long-term care institutions than their male counterparts,” Saposnik said. “In addition, those over 80, who were admitted to a non-academic and rural institutions were more likely to die from stroke, while non-specialist care was linked to a 14 per cent higher rate of death at discharge among the age group.”
 
These findings have important practical implications for clinical management and preventive strategies and health policy, the authors said.
 
“Our study should encourage further research to identify potentially remediable factors related to delivery of care to reduce morbidity and mortality in more elderly patients with stroke. The recognition of this growing problem may help to implement strategies aimed at involving more elderly subjects in clinical trials and other research, facilitating access to specialized stroke care and improving survival and quality of life in the elderly.”
 
St. Michael’s Hospital is a large and vibrant Catholic teaching and research hospital in the heart of Toronto. Fully affiliated with the University of Toronto, St. Michael’s Hospital leads with innovation, and serves with compassion. Renowned for providing exceptional patient care, St. Michael’s Hospital is a regional trauma centre and downtown Toronto’s designated trauma centre for adults.