cerebro-vascular pathology of elderly diabetics 72 case-studies s. hannat - r. chermat - r. malek...
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Cerebro-Vascular Pathology of Elderly diabetics
72 case-studies
S. Hannat - R. Chermat - R. Malek
Internal Medical Service
University Hospital Centre Setif
Algeria
Malta, April 23–26, 2009
Introduction
Stroke affects more than 700,000 individuals each year.
it is the third largest cause of death and the largest cause of adult disability in the U.S A (1).
Diabetes is clearly one of the most important risk factors for ischemic stroke(2).
Diabetes is associated with an increased incidence of stroke and death among elderly people (3)
(1)Stroke. 2008;39:1142-1147.
(2) Diabetes Care 30:3131-3140, 2007
(3) Journal of Gerontology 2004, Vol. 59A, No. 6, 640–645
Objectives
Estimate the incidence of stroke among hospitalized diabetics.
Analyze the type and the progression of the stroke
Characteristics of the elderly patient
Patients and Methodology Retrospective studyTarget population: elderly diabetics Duration: 3 years Parameters studied: - age, gender, onset of diabetes, lipid check up, HbA1c
- Check up of complications
- Associeted causes of morbidity
Number of stroke among elderly diabetics / Total number of hospitalized diabetics
0
200
400
600
800
1000
total number ofhospitalizeddiabetics number of strokeamong elderlydiabetes
803
72
9% ±1,96 (95% CI 7,04 to 10,96)
Number of stroke among elderly diabetics / Total number of stroke
0
40
80
120
160157
72
46% ± 7,78 (95% CI 54 to 38)
Total number of stroke
Number of stroke among elderly diabetics
Distribution by gender Blood glucose control on admission
Ratio 1M / 2W
Total number of stroke 72
Averrage lenght of the evolution of diabetes : 10 years ± 3,76 years
Men
Woman
24
48
HbA1c %
< 7% 9 %
>7% et < 10 % 46%
> 10% 45 %
Distribution by age range
0
5
10
15
20
25
30
35
(65-74)y (75-84)y over 85y
« Young-old » 65 - 74 years
« Middle-old» 75 - 84 years
« Old-old» over 85 years
Elderly adult : WHO > 65 years
Woman
Men
(y)
Type of stroke Short Term Progress
87%
13%
ischemic
haemorrhagic
0
10
20
30
40
50
60 73,6%
19,4%6,94%
Comments Stroke is common in elderly diabetics.
9 % hospitalized diabetics had stroke.
46% of all stroke victims are elderly diabetics
A majority of stroke victims are women (gender ratio 0,5).
The highest frequency of stroke victims is in the 65-74 years age range.
Comments The onset of type II diabetes as well as chronic imbalance
could be risk factors in the occurance of a complication. Ischemic stroke is the predominant type.
The risk is usually higher among hypertensive elderly diabetics with atrial fibrillation or previous stroke.
Immediate progress : High mortality rate (20% of cases).