Case-fatality, disability and recurrence rates after first-ever stroke: A study from bigdata observatory platform for stroke of China

Abstract

BackgroundThere is currently a lack of data on stroke hospitalizations and long-term outcomes in China. Therefore, we investigated 12-month stroke fatality, disability, and recurrence rates after the first-ever stroke. MethodsThis was a prospective nationwide hospital-based cohort study. From August to September 2019, all patients with first-ever stroke (ischemic stroke [IS], intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) and with symptom onset within 14 days from 232 hospitals were included. Case fatality, disability, and recurrence rates for one year were estimated. ResultsIn total, 36250 first-ever stroke patients from 194 hospitals were recruited (median age was 65(IQR, 56-73) years and 61.4 % were male). The rate of intravenous thrombolysis and endovascular treatment for IS were 9.5 % and 4.4 %, respectively. In-hospital death rate was 1.9 % (95 %CI: 1.7 %–2.0 %) for stroke inpatients, ranging from 0.9 % (0.8 %–1.1 %) for IS to 5.1 % (4.6 %–5.6 %) for ICH. The 12-month fatality rate was 8.6 % (95 %CI: 8.3 %–8.9 %) for discharged stroke patients, ranging from 6.0 % (5.7 %–6.3 %) for IS to 17.7 % (16.7 %–18.7 %) for ICH. The 12-month disability rate was 16.6 % (95 %CI: 16.2 %–17.0 %) for stroke survivors, ranging from 11.1 % (9.3 %–12.8 %) for SAH to 29.2 % (27.9 %–30.4 %) for ICH. The stroke recurrence rate was 5.7 % (5.5 %–6.0 %) for stroke survivors, ranging from 2.5 % (1.7 %–3.3 %) for SAH to 6.4 % (6.0 %–6.7 %) for IS. ConclusionOur results support the hypothesis that the prognosis of Chinese stroke patients appears to have improved and is not very bad.