Stroke, Vol 24, 796-800, Copyright © 1993 by American Heart Association
MS Dennis, JP Burn, PA Sandercock, JM Bamford, DT Wade and CP Warlow
BACKGROUND AND PURPOSE: There have been relatively few community-based
studies of long-term prognosis after acute stroke. This study aimed to
provide precise estimates of the absolute and relative risks of dying in an
unselected cohort of patients with a first-ever stroke. METHODS: Six
hundred seventy-five patients were registered by a community-based stroke
register (the Oxfordshire Community Stroke Project) and prospectively
followed up for up to 6.5 years. Their relative risk of death was
calculated using age- and sex-specific mortality rates for Oxfordshire.
RESULTS: During the first 30 days, 129 (19%) patients died. Patients who
survived at least 30 days after a first-ever stroke thereafter had an
average annual risk of death of 9.1%, 2.3-fold the risk in people from the
general population. Although the absolute (about 15%) and relative (about
threefold) risks of death were highest in these 30-day survivors over the
first year after the stroke, they were at increased risk of dying over the
next few years (range of relative risk for individual years, 1.1-2.9).
Predictably, older patients had a worse absolute survival but, relative to
the general population, stroke also increased the relative risk of dying in
younger patients. During the first 30 days stroke accounts for most deaths;
after this time nonstroke cardiovascular disease becomes increasingly
important and is the most common cause of death after the first year.
CONCLUSIONS: These data highlight the importance of long-term secondary
prevention of vascular events in stroke patients, targeted as much at the
cardiovascular as at the cerebrovascular circulation.
ARTICLES
Long-term survival after first-ever stroke: the Oxfordshire Community Stroke Project
Department of Clinical Neurosciences, Western General Hospital, Edinburgh, U.K.
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J. W. Hop, G. J.E. Rinkel, A. Algra, and J. van Gijn Case-Fatality Rates and Functional Outcome After Subarachnoid Hemorrhage : A Systematic Review Stroke, March 1, 1997; 28(3): 660 - 664. [Abstract] [Full Text]
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B. F. Gage, A. B. Cardinalli, and D. K. Owens The Effect of Stroke and Stroke Prophylaxis With Aspirin or Warfarin on Quality of Life Arch Intern Med, September 9, 1996; 156(16): 1829 - 1836. [Abstract] [PDF]
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J.H.P. van der Meulen, M. Limburg, A. van Straten, and J.D.F. Habbema Computed Tomographic Brain Scans and Antiplatelet Therapy After Stroke : A Study of the Quality of Care in Dutch Hospitals Stroke, April 1, 1996; 27(4): 633 - 638. [Abstract] [Full Text]
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A. V. Salgado, J. M. Ferro, and A. Gouveia-Oliveira Long-term Prognosis of First-Ever Lacunar Strokes : A Hospital-Based Study Stroke, April 1, 1996; 27(4): 661 - 666. [Abstract] [Full Text]
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B. F. Gage, A. B. Cardinalli, G. W. Albers, and D. K. Owens Cost-effectiveness of Warfarin and Aspirin for Prophylaxis of Stroke in Patients With Nonvalvular Atrial Fibrillation JAMA, December 20, 1995; 274(23): 1839 - 1845. [Abstract] [PDF]
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S. M. Lai, M. Alter, G. Friday, and E. Sobel Prognosis for Survival After an Initial Stroke Stroke, November 1, 1995; 26(11): 2011 - 2015. [Abstract] [Full Text]
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L. Bergman, J. H.P. van der Meulen, M. Limburg, and J. D. F. Habbema Costs of Medical Care After First-Ever Stroke in the Netherlands Stroke, October 1, 1995; 26(10): 1830 - 1836. [Abstract] [Full Text]
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J. Tuomilehto, T. Nuottimaki, K. Salmi, K. Aho, M. Kotila, C. Sarti, and D. Rastenyte Psychosocial and Health Status in Stroke Survivors After 14 Years Stroke, June 1, 1995; 26(6): 971 - 975. [Abstract] [Full Text]
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