Published online before print July 3, 2003, doi: 10.1161/01.STR.0000082382.42061.EE
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(Stroke. 2003;34:1842.)
© 2003 American Heart Association, Inc.
Original Contributions |
Ten-Year Survival After First-Ever Stroke in the Perth Community Stroke Study
School of Population Health, University of Western Australia; Stroke Unit, Department of Neurology, Royal Perth Hospital, Western Australia; Department of Medicine, University of Western Australia; Imperial College of Science, Technology and Medicine, London; Clinical Trials Research Unit, University of Auckland, New Zealand
Correspondence to Professor G.J. Hankey, Department of Neurology, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia 6001. E-mail gjhankey{at}cyllene.uwa.edu.au
Background and Purpose— Very few studies have provided information regarding long-term prognosis after stroke. We aimed to determine the absolute and relative survival over 10 years among patients with first-ever stroke from a population-based study in Perth, Western Australia.
Methods— For a 12-month period beginning February 1989, all individuals with a suspected acute stroke or transient ischemic attack who were resident in a geographically defined and representative region of Perth, Western Australia, were registered prospectively and assessed according to standardized diagnostic criteria. Patients with a definite first-ever stroke were followed up prospectively at 4 months, 12 months, 5 years, and 10 years after the index event.
Results— A total of 251 patients with first-ever stroke were registered, and 244 (97%) were followed up at 10 years, by which time 197 (79%; 95% confidence interval [CI], 74 to 84) had died. The major causes of death were the direct effects of the initial stroke (27%; 95% CI, 21 to 33) and cardiovascular disease (26%; 95% CI, 20 to 32). Among 1-year survivors of stroke, the average annual case fatality was 4.8%, which was 2.3 (95% CI, 1.9 to 2.7) times greater than for the general population of the same age and sex.
Conclusions— One in 5 patients with first-ever stroke survived to 10 years. The average annual case fatality was 4.8% between years 1 and 10 after stroke, which was twice that expected for the general population. Vascular disease is the major cause of death among long-term survivors of stroke.
Key Words: Australia • stroke • survival
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