Stroke, Vol 25, 333-337, Copyright © 1994 by American Heart Association
J Burn, M Dennis, J Bamford, P Sandercock, D Wade and C Warlow
BACKGROUND AND PURPOSE: There have been few community-based studies of
long-term prognosis after acute stroke. This study aims to provide precise
estimates of the absolute and relative risks of stroke recurrence in an
unselected cohort of patients with a first-ever stroke. METHODS: Six
hundred seventy-five patients were registered in a community-based stroke
register (the Oxfordshire Community Stroke Project) and prospectively
followed for up to 6.5 years. Their relative risk of recurrent stroke was
calculated using age- and sex-specific incidence rates for first stroke in
Oxfordshire. RESULTS: One hundred eighty recurrent episodes of stroke were
identified, of which 135 were first recurrences. Given survival, the
actuarial risk of suffering a recurrence was 30% (95% confidence interval,
20% to 39%) by 5 years, about nine times the risk of stroke in the general
population. The risk was highest early after the first stroke: 13% (95%
confidence interval, 10% to 16%) by 1 year, 15 times the risk in the
general population. After the first year the average annual risk was about
4%. The risk of stroke recurrence did not appear to be related to age or
pathological type of stroke. CONCLUSIONS: The absolute and relative risks
of recurrent stroke are highest early after the first stroke but remain
elevated for several years thereafter. Efforts at secondary prevention
should be initiated as soon as possible and continued for several years to
gain greatest benefit.
ARTICLES
Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project [published erratum appears in Stroke 1994 Sep;25(9):1887]
Department of Rehabilitation Medicine, Southampton General Hospital, United Kingdom.
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