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Age Trajectories of Stroke Case Fatality: Leveling Off at the Highest Ages

Olsen, Tom Skyhøja; Andersen, Zorana Jovanovicb; Andersen, Klaus Kaaeb

doi: 10.1097/EDE.0b013e3182117b3d
Stroke: Original Article

Background: Mortality rates level off at older ages. Age trajectories of stroke case-fatality rates were studied with the aim of investigating prevalence of this phenomenon, specifically in case-fatality rates at older ages.

Methods: A registry of all hospitalized stroke patients in Denmark included 40,155 patients with evaluations of stroke severity, computed tomography, and cardiovascular risk factors. Data on mortality were used to construct age trajectories of 3-day, 1-week, 1-month, and 1-year case-fatality rates in men and women.

Results: Of the 40,155 patients, 19,301 (48%) were women (mean age, 74.5 years) and 20,854 (52%) were men (mean age, 69.7 years). In both women and men, 3-day case-fatality rates leveled off, beginning in the patients' mid-70s. In women, 1-week case-fatality rates leveled off further in their early 80s, whereas in men, 1-week case-fatality rates accelerated with age. One-month and 1-year case-fatality rates accelerated with age for both sexes.

Conclusions: It is an apparent paradox that case-fatality rates in the acute state of stroke level off at the highest ages. Heterogeneity, innate or acquired, in regard to survival capacity may explain the phenomenon.

From the aThe Stroke Unit, Frederiksberg Hospital, Frederiksberg, Denmark; and bInstitute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark.

Submitted 20 July 2010; Accepted 19 November 2010; posted 23 February 2011.

Correspondence: Tom Skyhøj Olsen, The Stroke Unit, NA-amb, Frederiksberg University Hospital, DK-2000 Frederiksberg, Denmark. E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.