This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hallström, B. Articles by Lindgren, A. Search for Related Content PubMed PubMed Citation Articles by Hallström, B. Articles by Lindgren, A. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Acute Cerebral Hemorrhage Acute Cerebral Infarction Acute Stroke Syndromes Cerebral Aneurysm, AVM, & Subarachnoid hemorrhage Cerebral Lacunes

(Stroke. 2002;33:1624.)
© 2002 American Heart Association, Inc.

Original Contributions

Stroke in Lund-Orup, Sweden

Improved Long-Term Survival Among Elderly Stroke Patients

Björn Hallström, MD; Bo Norrving, MD Arne Lindgren, MD

From Lund Stroke Center, Department of Clinical Neuroscience, Division of Neurology, University Hospital, Lund, Sweden.

Correspondence to Björn Hallström, MD, Lund Stroke Center, Department of Clinical Neuroscience, Division of Neurology, University Hospital, S-221 85 Lund, Sweden. E-mail bjorn.hallstrom{at}skane.se

Background and Purpose— Several studies report declining early stroke case fatality, but the findings are not consistent across geographic areas. Corresponding changes in long-term survival are less well documented. We recently reported increased stroke incidence among patients aged <75 years and stable incidence among older persons. We now report temporal trends for early and late case fatality among patients with stroke onset during 1983–1985 and 1993– 1995.

Methods— Patients living within the Lund-Orup, Sweden, hospital district and fulfilling the diagnostic criteria for first-ever stroke during 1983–1985 (n=998) and 1993–1995 (n=1318) were followed up concerning survival status at 28 days, 1 year, and 3 years. Age and sex adjustments were performed. The possible influence of Oxfordshire Community Stroke Project (OCSP) stroke subtypes on survival was also analyzed.

Results— Overall survival improved between the study periods (Cox proportional hazards regression: hazard ratio, 0.84; 95% confidence limits, 0.75 to 0.94; P=0.0019). The 28-day case fatality was 15% for stroke patients from both study periods. One-year case fatality was 31% for 1983–1985 patients and 27% for 1993–1995 patients. The corresponding figures at 3 years were 44% and 40%, respectively. In the group aged <75 years, there were no significant changes in overall survival, but survival improved significantly among patients aged 75 years beyond 28 days after stroke onset. OCSP stroke subtype was an independent predictor of death (P<0.0001).

Conclusions— The recently observed increase in stroke incidence among patients aged <75 years was not accompanied by changing survival in that age group. However, among patients aged 75 years, survival improved beyond 28 days after stroke. The causes of this change in survival are unknown but may be related to improved long-term care of elderly stroke patients.

Key Words: elderly • epidemiology • stroke • survival • Sweden

This article has been cited by other articles:

				E. Zia, G. Engstrom, P. J. Svensson, B. Norrving, and H. Pessah-Rasmussen Three-Year Survival and Stroke Recurrence Rates in Patients With Primary Intracerebral Hemorrhage Stroke, November 1, 2009; 40(11): 3567 - 3573. [Abstract] [Full Text] [PDF]

				B. Hallstrom, A.-C. Jonsson, C. Nerbrand, B. Norrving, and A. Lindgren Stroke Incidence and Survival in the Beginning of the 21st Century in Southern Sweden: Comparisons With the Late 20th Century and Projections Into the Future Stroke, January 1, 2008; 39(1): 10 - 15. [Abstract] [Full Text] [PDF]

				R. Carandang, S. Seshadri, A. Beiser, M. Kelly-Hayes, C. S. Kase, W. B. Kannel, and P. A. Wolf Trends in Incidence, Lifetime Risk, Severity, and 30-Day Mortality of Stroke Over the Past 50 Years JAMA, December 27, 2006; 296(24): 2939 - 2946. [Abstract] [Full Text] [PDF]

				N. J. Bainbridge, M. W. J. Davie, and M. J. Haddaway Bone loss after stroke over 52 weeks at os calcis: influence of sex, mobility and relation to bone density at other sites Age Ageing, March 1, 2006; 35(2): 127 - 132. [Abstract] [Full Text] [PDF]

				R Fogelholm, K Murros, A Rissanen, and S Avikainen Long term survival after primary intracerebral haemorrhage: a retrospective population based study J. Neurol. Neurosurg. Psychiatry, November 1, 2005; 76(11): 1534 - 1538. [Abstract] [Full Text] [PDF]

				M. Eriksson, K. Asplund, E.-L. Glader, B. Norrving, B. Stegmayr, A. Terent, K. H. Asberg, P.-O. Wester, and for The Riks-Stroke Collaboration Self-Reported Depression and Use of Antidepressants After Stroke: A National Survey Stroke, April 1, 2004; 35(4): 936 - 941. [Abstract] [Full Text] [PDF]

				A. Terent Trends in Stroke Incidence and 10-Year Survival in Soderhamn, Sweden, 1975-2001 Stroke, June 1, 2003; 34(6): 1353 - 1358. [Abstract] [Full Text] [PDF]