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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|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 K. Fox Poststroke patients: implications for the cardiologist Eur. Heart J. Suppl., July 1, 2003; 5(suppl_E): E4 - E10. [Abstract] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
 |
|
 R. Kelly, A. Staines, R. MacWalter, P. Stonebridge, H. Tunstall-Pedoe, and A. D. Struthers The prevalence of treatable left ventricular systolic dysfunction in patients who present with noncardiac vascular episodes: A case-control study J. Am. Coll. Cardiol., January 16, 2002; 39(2): 219 - 224. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
H. M. Dewey, A. G. Thrift, C. Mihalopoulos, R. Carter, R. A.L. Macdonell, J. J. McNeil, and G. A. Donnan Cost of Stroke in Australia From a Societal Perspective: Results From the North East Melbourne Stroke Incidence Study (NEMESIS) Stroke, October 1, 2001; 32(10): 2409 - 2416. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Intra-arterial Thrombolysis AJNR Am. J. Neuroradiol., September 1, 2001; 22(2007): 18S - 21S. [Full Text] [PDF]
|
|
|
|
|
|
H. Bronnum-Hansen, M. Davidsen, and P. Thorvaldsen Long-Term Survival and Causes of Death After Stroke Stroke, September 1, 2001; 32(9): 2131 - 2136. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
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|
|
|
|
|
|
W.T. Longstreth Jr., C. Bernick, A. Fitzpatrick, M. Cushman, L. Knepper, J. Lima, and C.D. Furberg Frequency and predictors of stroke death in 5,888 participants in the Cardiovascular Health Study Neurology, February 13, 2001; 56(3): 368 - 375. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Leys Atherothrombosis - the neurologist's point of view Vascular Medicine, February 1, 2001; 6(1_suppl): 17 - 19. [Abstract] [PDF]
|
|
|
|
|
|
K N Vemmos, M L Bots, P K Tsibouris, V P Zis, C E Takis, D E Grobbee, and S Stamatelopoulos Prognosis of stroke in the south of Greece: 1 year mortality, functional outcome and its determinants: the Arcadia Stroke Registry J. Neurol. Neurosurg. Psychiatry, November 1, 2000; 69(5): 595 - 600. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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|
|
|
|
|
|
G. J. Hankey, K. Jamrozik, R. J. Broadhurst, S. Forbes, P. W. Burvill, C. S. Anderson, and E. G. Stewart-Wynne Five-Year Survival After First-Ever Stroke and Related Prognostic Factors in the Perth Community Stroke Study Stroke, September 1, 2000; 31(9): 2080 - 2086. [Abstract] [Full Text] [PDF]
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 |
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 F. A. McAlister, A. M. O'Connor, G. Wells, S. A. Grover, and A. Laupacis When should hypertension be treated? The different perspectives of Canadian family physicians and patients Can. Med. Assoc. J., August 1, 2000; 163(4): 403 - 408. [Abstract] [Full Text] [PDF]
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