Predictors of long-term survival among first-ever ischemic and hemorrhagic stroke in a Brazilian stroke cohort

Goulart, Alessandra Carvalho; Fernandes, Tiótrefis Gomes; Santos, Itamar S; Alencar, Aline Paixão; Lotufo, Paulo A

doi:10.1016/j.jns.2013.07.659

Cited by 5 publications

(6 citation statements)

References 7 publications

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“…The EMMA (Estudo de Mortalidade e Morbidade do Acidente Cerebro Vascular) study in Sao Paulo was able to identify differences in lethality and disability among people who had the same care during the acute stroke rates. After one and four years of follow-up, stroke suffers who had fewer years of formal education had a lower survival and a higher frequency of disability compared with who had more years of schooling (8,9). One alternative point to explain differences in incidence and lethality is related to race.…”

Section: Discussionmentioning

confidence: 99%

Income inequalities and stroke mortality trends in Sao Paulo, Brazil, 1996-2011

Fernandes

Bando

Alencar

et al. 2015

International Journal of Stroke

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Section: Discussionmentioning

confidence: 99%

Income inequalities and stroke mortality trends in Sao Paulo, Brazil, 1996-2011

Fernandes

Bando

Alencar

et al. 2015

International Journal of Stroke

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“…The covariates examined included age (per 5-year increase above 65), marital status (married/not married), hypertension, diabetes, COPD, history of CAD, AF, anemia, renal dysfunction (estimated glomerular filtration rate <60 mL/min/1.73 m2), time from stroke onset to rehabilitation admission <30 days, ischemic stroke, dysphagia, neglect, motor FIM score at admission, and cognitive FIM score at admission. These variables were selected based on availability at time of presentation and prior studies showing an association with the outcomes of interest (4,6,11,12,17,(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32) and were included in all analyses.…”

Section: Covariatesmentioning

confidence: 99%

Sex Differences in Long-Term Mortality and Functional Outcome After Rehabilitation in Patients With Severe Stroke

et al. 2020

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Objective: We sought to determine sex differences in outcomes in patients with severe stroke who had been admitted to inpatient rehabilitation.Methods: We studied 1,316 patients aged 18 to 99 (mean 72) classified as case-mix groups 0108, 0109, and 0110 of the Medicare case-mix classification system. These groups encompass the most severe strokes. Three outcomes were analyzed: (1) 3-year mortality from admission to rehabilitation; (2) combined outcome of transfer to acute care or death within 90 days from admission to rehabilitation; (3) functional outcome, including proportional recovery in motor functioning and good functional outcome as defined by achievement of a Functional Independence Measure (FIM)-motor score ≥65 points at discharge. Multivariable regression analyses were used to assess sex-difference in each outcome between women and men. The covariates examined included age, marital status, comorbidities, time from stroke onset to rehabilitation admission <30 days, ischemic stroke, dysphagia, neglect, motor FIM score at admission, and cognitive FIM score at admission.Results: Kaplan-Meier estimated 3-year mortality rate was 20.7% in women and 22.0% in men. The crude hazard ratio (HR) of death for women compared with men was 0.94 (95% CI 0.74-1.20). After adjustment for significant covariates, the HR of 3-year mortality was 0.73 (95% CIs 0.56-0.96; p = 0.025). Comorbidity, including diabetes, anemia, coronary artery disease, atrial fibrillation, and chronic obstructive pulmonary disease, significantly increased mortality risk by 49-88%. The incidence of the combined outcome was 8.3% in women and 8.4% in men. The crude HR of the combined end-point for women compared with men was 1.05 (95% CI 0.72-1.53). After adjustment for significant covariates, the HR was 0.95 (95% CIs 0.65-1.40; p = 0.810). Likewise, no significant difference in proportional recovery or in the rate of achievement of a good functional outcome between women and men was observed.Conclusion: Among patients admitted to inpatient rehabilitation after severe stroke, women and men had comparable crude mortality rates at 3 years. After multivariable Scrutinio et al.Sex Differences in Severe Stroke adjustment, however, women had lower mortality risk. No sex-differences in the risk of being transferred to acute care or dying within 90 days from admission to rehabilitation or in responsiveness to rehabilitation were observed.

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“…outcome (8,9). In young patients with an incident ischemic stroke, type 1 diabetes independently increased the risk of 5-year mortality more than threefold (10).…”

mentioning

confidence: 99%