Survival, causes of death and recurrence up to 3 years after stroke : A population-based study

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Aked, JosephLund University,Lunds universitet,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Clinical Stroke Research Group,Lund University Research Groups,Blekinge Hospital (författare)

Survival, causes of death and recurrence up to 3 years after stroke : A population-based study

Artikel/kapitelEngelska2021

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2021-08-08
Wiley,2021

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LIBRIS-ID:oai:lup.lub.lu.se:737bb5ff-8aad-48dc-bda7-0f0a2b5d4cca
https://lup.lub.lu.se/record/737bb5ff-8aad-48dc-bda7-0f0a2b5d4ccaURI
https://doi.org/10.1111/ene.15041DOI

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Språk:engelska
Sammanfattning på:engelska

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Background and purpose: Up-to-date population-based information about long-term survival, causes of death and recurrence after stroke is needed. Methods: Four hundred consecutive individuals in a population-based cohort of first-ever stroke between 2015 and 2016 in Lund, Sweden, were followed up to 3 years regarding (i) survival (Swedish Population Register); (ii) causes of death (Swedish Causes of Death Register); and (iii) stroke recurrence (interview and medical chart review). Index and recurrent ischaemic stroke cases were classified using the Trial of ORG 10172 in Acute Stroke Treatment (TOAST) and Oxfordshire Community Stroke Project; and comorbidities were classified using the Charlson Comorbidity Index. Cox regression was used to determine predictors for 3-year mortality. Survival rates were compared with three local studies over a 30-year timespan. Results: Amongst 400 first-ever stroke patients, 265 (66%) survived 3 years post-stroke. Age (hazard ratio [HR] 1.09; 95% confidence interval [CI] 1.06–1.11), stroke severity (HR 1.11; 95% CI 1.08–1.13) and comorbidities (HR 1.36; 95% CI 1.22–1.53) were independently related to 3-year mortality. Amongst index ischaemic stroke patients, survival was lowest amongst those with cardio-aortic embolism (51/91; 56%). Cerebrovascular disease (54/135; 40%) and ischaemic heart disease (25/135; 19%) were the most common causes of death. Within 3 years, 30 (8%) had recurrent stroke. Amongst patients with index ischaemic stroke, 16/29 (55%) had a different TOAST pathogenetic mechanism or hemorrhagic stroke upon recurrence. Stroke survival improved between 1983–1985 and 2015–2016 (p = 0.002), but no significant change was observed between 2001–2002 and 2015–2016 (p = 0.48). Conclusions: Stroke survival rates are relatively high, but their improvement over recent decades may be slowing down, possibly due to the composition of the first-ever stroke population. The common occurrence of changed pathogenetic mechanisms between first-ever and recurrent stroke highlights the value of reassessment in recurrent stroke.

Ämnesord och genrebeteckningar

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
outcome
recurrent stroke
stroke
survival

Biuppslag (personer, institutioner, konferenser, titlar ...)

Delavaran, HosseinLund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Stroke Research Group,Lund University Research Groups,Danderyd Hospital(Swepub:lu)med-hmh (författare)
Lindgren, Arne G.Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Klinisk strokeforskning,Forskargrupper vid Lunds universitet,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Stroke Research Group,Lund University Research Groups,Skåne University Hospital(Swepub:lu)neur-ali (författare)
Klinisk strokeforskningForskargrupper vid Lunds universitet (creator_code:org_t)

Sammanhörande titlar

Ingår i:European Journal of Neurology: Wiley28:12, s. 4060-40681351-51011468-1331

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Av författaren/redakt...: Aked, Joseph; Delavaran, Hosse ...; Lindgren, Arne G ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

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Av lärosätet: Lunds universitet

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