Assessment of Cerebrovascular Accident and Transient Ischemic Attack Risk Factors in Elderly vs. Non-Elderly Patients at a Tertiary Care Hospital in Eastern Province, Saudi Arabia

Ahmed S Mohammedin; Wesal S Horaib; Razan A Alshamsi; Sallumah O Alrashdi; Dalal A Aleidi; Mudhawi S Al Subaie; Noor-Ahmed Jatoi

doi:10.7759/cureus.18391

Assessment of Cerebrovascular Accident and Transient Ischemic Attack Risk Factors in Elderly vs. Non-Elderly Patients at a Tertiary Care Hospital in Eastern Province, Saudi Arabia

Cureus. 2021 Sep 30;13(9):e18391. doi: 10.7759/cureus.18391. eCollection 2021 Sep.

Authors

Ahmed S Mohammedin^{1

2}, Wesal S Horaib³, Razan A Alshamsi³, Sallumah O Alrashdi³, Dalal A Aleidi³, Mudhawi S Al Subaie³, Noor-Ahmed Jatoi⁴

Affiliations

¹ Geriatric Medicine, Ain Shams University Hospital, Cairo, EGY.
² Geriatric Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU.
³ Internal Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU.
⁴ Vascular Medicine, King Fahad Hospital of the University, Imam Abdulrahman bin Faisal University, Khobar, SAU.

Abstract

Background The survivors of cerebrovascular accidents (CVA) or stroke are often left with several mental and physical disabilities which create a major social and economic burden. However, research addressing the risk factors of CVA and transient ischemic attacks (TIA), and their complications are insufficient. Aim of the study To assess the CVA and TIA risk factors (hypertension, diabetes mellitus type 2, dyslipidemia, coronary artery disease, atrial fibrillation, obesity, hypercoagulopathy, anti-platelet and anticoagulant use, carotid artery stenosis, and hypothyroidism) and complications (pneumonia, urinary tract infection and deep venous thrombosis) among a sample of elderly patients compared to non-elderly adult patients receiving care at King Fahd Hospital of the University in Al-Khobar, Saudi Arabia. Methods A retrospective observational study was conducted at King Fahd Hospital of the University in Al-Khobar, Saudi Arabia. Multiple risk factors and complications of CVA and TIA were retrieved from the medical records of the studied patients that fulfilled the inclusion criteria of patients diagnosed with CVA and TIA aged ≥ 60 years (elderly sample) and 18-59 years old (comparison non-elderly sample), who were followed up by internal medicine, neurology, and geriatric medicine departments. The total participant size was 259 patients, of which 149 were elderly. Results The occurrence of risk factors was more common in the senior age group. Hypertension was the most frequent risk factor in both age groups, while dyslipidemia, atrial fibrillation, and obesity were significantly associated with the development of CVA and TIA in the elderly. Moreover, post-CVA and TIA complications were more frequent in the group with elderly patients, with urinary tract infections being the most reported complication. Conclusion This study concluded that the most frequent risk factors were hypertension and type 2 diabetes mellitus. The findings of this study call for providing extra preventive care for elderly patients with dyslipidemia, atrial fibrillation, and obesity, and for more aggressive prevention of post-CVA and TIA complications in older age groups.

Keywords: cerebrovascular accidents; older adults; stroke; stroke complications; stroke risk factors; transient ischemic attack.