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(Stroke. 2003;34:2876.)
© 2003 American Heart Association, Inc.

Original Contributions

Predictors of Death Among Long-Term Stroke Survivors

From the Institute of Community Medicine (T.E., E.A.) and Department of Geriatric Medicine (M.V.), University of Tromsø, Tromsø, Norway; and Department of Geriatric Medicine, University of Turku, Turku, Finland (M.V.).

Correspondence to Torgeir Engstad, Faculty of Medicine, Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. E-mail Torgeir.Engstad{at}ism.uit.no

Background and Purpose— We evaluated the risk factors for death among long-term stroke survivors compared with stroke-free subjects.

Methods— In 1997 we investigated 221 stroke survivors (mean, 9.4 years after index stroke) and 243 stroke-free subjects; both groups were recruited from a population-based health study. During the subsequent 5 years, all deaths (51 and 21 in the stroke and stroke-free groups, respectively) were registered.

Results— The age- and sex-adjusted total mortality rate for the 5-year follow-up was 21.0% in the stroke group and 7.9% in the stroke-free group (P<0.0001), depending on different rates of cardiovascular deaths (P<0.0001). Better physical and social functioning (P<0.0001) and moderate use of alcohol (P0.004), the latter compared with no use, decreased risk of death, irrespective of stroke status. A myocardial infarction risk score had no impact on death in the stroke group, in contrast to the increased risk seen among the stroke-free group (P=0.0001).

Conclusions— The long-term stroke survivors had significant excess risk of death compared with stroke-free subjects. Better physical and social functioning and moderate use of alcohol were associated with decreased risk, whereas a myocardial infarction risk score increased risk for death only in the stroke-free group.

Key Words: mortality • risk factors • stroke

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