Five-year survival after stroke

Abstract

Five-year survival of Grodno’s inhabitants who had a stroke in 2001 was investigated. Patients followed up prospectively up to 5 years from the beginning of the disease; complete data after 5 years were available for 853 of 875 patients (97.5%). The cumulative five-year death risk, 63.0%, was 2.9 times greater than for people of the same age and sex in Grodno’s general population. The relative death risk was the highest in patients younger than 45 years (55.0) and decreased to 1.1 in patients older than 84 years. The significant distinction in 5-year survival in patients with different types of stroke (subarachnoid hemorrhage – 0.68; cerebral infarction – 0.41; intracerebral hemorrhage – 0.17; undetermined stroke – 0.08) was mostly determined by the influence of acute stage rates and decreased to small non-significant values in a group of 28-day survivors. Stroke (including the recurrent episodes) was the prevalent cause of death during the first year in 28-day survivors (67.0%), where as other cardiovascular diseases were the main causes of death (62.0%) during the later period. The significant prognostic factors of the 5-year death risk after stroke were age (hazard ratio (HR) 1.04), stroke in anamnesis (HR 1.48), arterial hypertension (HR 0.76), and diabetes mellitus (1.26). In 28-day survivors the significant prognostic factors of the 5-year death risk were age (HR 1.05), stroke in anamnesis (HR 1.62), diabetes mellitus (HR 1.46), atrial fibrillation (HR 1.34), and myocardial infarction in anamnesis (HR 1.43). The obtained data shows strong necessity of secondary prevention, focused both on cerebral and heart vascular pools.