Factors Predicting Stroke Mortality in Thailand: Thai Epidemiologic Stroke Study

Abstract

Objective: To determine the factors predicting stroke mortality in Thailand. Materials and Methods: The Thai Epidemiologic Stroke (TES) study is a prospective community-based cohort study that recruited participants from the general population from five regions of Thailand. Between 2004 and 2006, 19,620 participants aged 45 to 80 years, free of stroke, took part in the baseline survey. The participants were followed up for mortality over 12 years. Competing risk regression analysis was used to identify the predictors of stroke mortality. Subdistribution hazard ratio (SHR) and 95% confidence intervals were used to illustrate the associations. Results: During a median follow-up time of 11.1 years (202,803 person-years), 305 participants died of stroke, and 3,176 participants died of non-stroke cause. In multivariate analysis, older age group (70 to 80 years) (SHR 3.37, 95% CI 2.25 to 5.04), geographic region, that was, living in northeastern region (SHR 2.05, 95% CI 1.26 to 3.34), hypertension (SHR 2.05, 95% CI 1.56 to 2.68), current smoker (SHR 1.97, 95% CI 1.33 to 2.91), and men (SHR 1.46, 95% CI 1.01 to 2.10) were significantly associated with a higher risk of stroke mortality. Whereas hypercholesterolemia was significantly associated with a lower risk of stroke death (SHR 0.74, 95% CI 0.57 to 0.96). Marital status, education level, occupation, low personal income, alcohol consumption, body mass index, diabetes mellitus, and snoring were not significantly related to stroke mortality. Conclusion: Older age, geographic region (northeastern region), hypertension, current smoker, and men were significant predictors of a higher risk of stroke mortality. Clinical preventive focus targeting these groups may reduce the stroke mortality in the Thai population. Keywords: Thailand, Stroke, Mortality, Risk factor