Survival of Ischaemic and Haemorrhagic Stroke: Analysis of the Malaysian National Stroke Registry Data from 2009 to 2013.

Abstract

Stroke ranks as the second leading cause of death globally, contributing to 15.2 million deaths in 2016. In Malaysia, stroke has emerged as a significant cause of mortality and disability. This study aims to evaluate the survival time and rate of stroke patients in Malaysia. In this retrospective cohort study, we reviewed secondary data from the National Stroke Registry (NSR) of Malaysia. The study included all Malaysian residents over the age of 12 years old diagnosed with either ischaemic or haemorrhagic stroke between 1 January 2009 and 31 December 2013. Patients with a transient ischaemic attack were excluded. We updated the death status up to 31 December 2018 using mortality data from the Malaysian National Registry Department. We used Kaplan-Meier Survival Analysis to determine the overall median survival time and log-rank test to compare the median time by ethnicity, sex and stroke type. The survival rates at 1 year, 3 years and 5 years were obtained using the life-table method. The analysis included a total of 5,777 stroke patients. The mean age at diagnosis was 63.15 years old (with a standard deviation of 12.46 years old). The overall median survival time was 51 months (95% CI: 47.4, 54.6). Non-Malay patients and those with ischaemic strokes experienced a longer median survival time (65.2 months [95% CI: 56.6, 73.7] and 56.3 months [95% CI: 52.2, 60.3]), respectively. The survival rates at 1 year, 3 years and 5 years were 66.7% (95% CI: 65.5%, 68.0%), 55.6% (95% CI: 54.3%, 56.9%) and 46.9% (95% CI: 45.6%, 48.2%), respectively. There are significant differences in median survival time in relation to ethnicity and stroke types. Compared to other developed countries, Malaysia's 5-year survival rate is notably lower.