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(Stroke. 2004;35:1920.)
© 2004 American Heart Association, Inc.

Original Contributions

Very Long-Term Outcome After Stroke in Auckland, New Zealand

Craig S. Anderson, PhD, FRACP, FAFPHM; Kristie N. Carter, MSc; Wallace J. Brownlee, BHB; Maree L. Hackett, MA; Joanna B. Broad, MPH Ruth Bonita, PhD

From the Clinical Trials Research Unit (C.S.A., K.N.C., W.J.B., M.L.H.), Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand; the Section of Epidemiology and Biostatistics (J.B.B.), School of Population Health, University of Auckland, Auckland, New Zealand; and Non-Communicable Disease and Mental Health (R.B.), World Health Organization, Geneva, Switzerland.

Correspondence to Professor Craig Anderson, Clinical Trials Research Unit, The University of Auckland, Private Bag 92019, Auckland, New Zealand. E-mail c.anderson{at}ctru.auckland.ac.nz

Background and Purpose— Limited information exists on the long-term outcome from stroke. We aimed to determine survival and health status at 21-year follow-up of patients who participated in a population-based stroke incidence study undertaken in Auckland, New Zealand.

Methods— During 12 months beginning March 1, 1981, half of all residents of Auckland with acute first-ever or recurrent stroke (n=680) were assessed and followed up prospectively during the next 2 decades. In 2002, their vital status and health-related quality of life (HRQoL) using the 36-item short-form questionnaire (SF-36) were determined by telephone interviews. Kaplan–Meier survival probabilities for the stroke cohort were compared with life table estimates for the New Zealand population. The SF-36 profile of 21-year stroke survivors was compared with a standardized New Zealand population.

Results— Overall, 626 of the original cohort had died and 4 were lost to follow-up, leaving 50 (7%) individuals (57% male; mean age 70 years) available in 2002, of whom 12% were residents of an institutional care facility and 19% required help with everyday activities. The stroke cohort had nearly twice the mortality rate of the New Zealand population, but the SF-36 profile of very long-term stroke survivors was broadly similar to the general population.

Conclusions— Because stroke is generally a disease of older people and has a high case fatality, it is not surprising that <1 in 10 people survive 2 decades after onset. However, of those who do, their HRQoL profile suggests that they meld relatively successfully within the general population, despite ongoing disability and a higher mortality risk.

Key Words: stroke outcome • survival • quality of life

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