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(Stroke. 1999;30:894-895.)
© 1999 American Heart Association, Inc.

Letters to the Editor

Ischemic Stroke in Poland and the United States

Jaroslaw Pniewski, MD, PhD

Neurology Department, Medical Research Centre, Polish Academy of Sciences

Beata Szyluk, MD

Department of Neurology, Warsaw Medical School, Warsaw, Poland

Key Words: cerebrovascular disorders • mortality • young adults

To the Editor:

We, as neurologists, read with interest the report of Massing et al¹ on stroke mortality trends in Poland and the United States. The authors found different stroke mortality trends in the 2 countries (a decrease in the United States, an increase in Poland), a difference that was more pronounced in younger groups of patients. They concluded that the difference could have resulted from the effects of lifestyles and socioenvironmental and medical care determinants.

Our study on stroke in young adult patients has led us to similar conclusions. Between 1988 and 1995 in the Department of Neurology of the Medical Academy in Warsaw, we saw 71 patients (38 men and 33 women) aged 18 to 45 years (mean, 36.89±6.77 years) with a diagnosis of first-ever ischemic stroke. Four of our patients died within 28 days. All the deaths were atributed to the stroke. To assess long-term prognosis among this group of patients, we performed a follow-up study. We obtained precise information on 66 of 67 patients (98.5%) who survived the first stroke episode. The observation times varied from 4 months to 7 years (mean, 45.85±21.84 months). Two of the patients died during the observation time (both vascular deaths), and 9 others experienced a second ischemic stroke between 1 month and 6 years after the first (see the Figure).

View larger version (13K): [in this window] [in a new window]   Figure 1. Kaplan-Meier curve for combined vascular death and second, nonfatal stroke.

Calculated 28-day mortality in our group was 5.6%; the incidence of vascular death or recurrent stroke was . . . [Full Text of this Article]