Prognostic Factors in the Survival of 1,484 Stroke Cases Observed for 30 to 48 Months

SUMMARY All cases of first episodes of brain infarction occurring in the population of Rochester, Minnesota, from 1960 through 1979 were categorized as hemispheric or brainstem (including cerebellar) on the basis of clinical criteria, autopsy evidence, and the results of computed tomography (from 1973 on). Hemispheric infarction was 5 times more frequent than infarction of the brainstem and/or cerebellum. The magnitude of the decline in incidence was the same in each group during the 20-year period of the study. Thirty-day case fatality was similar in each group, but patients with brainstem infarction had a better longterm survival. Functional outcome among survivors of brainstem infarction was also better, 35% having returned to independent living by 1 year after onset compared with 22% of survivors of hemispheric infarction. This may have been a consequence of the higher proportion of residual cognitive and sensory impairments present in survivors of hemispheric infarction.

Section: Discussionsupporting

confidence: 92%

The natural history of hemispheric and brainstem infarction in Rochester, Minnesota.

Turney¹,

Garraway²,

Whisnant³

1984

“…Although the survival rate of patients with bleeding was very poor compared with that of patients with infarction, there was no significant difference in stroke type by sex (Table 2). Abu-Zeid et al 8 and Eisenberg et al 9 reported that the survival rate of males was better than that of females. However, some researchers 10 " 12 have reported no significant differences in survival rates by sex; moreover, Marshall and Shaw 13 reported that the survival rate of females was higher than that of males.…”

Section: Discussionmentioning

confidence: 98%

“…Abu-Zeid et al 8 reported that married stroke patients survived better than single patients, after adjusting for age. In our study, 90% of the male patients' wives but only 48% of the female patients' husbands (p<0.01) were alive.…”

Section: Discussionmentioning

confidence: 99%

Prognosis and disability of stroke patients after 5 years in Akita, Japan.

Kojima

Omura

Wakamatsu

et al. 1990

The system of registering stroke patients was begun in 1963 in Ikawa Town, Akita Prefecture, Japan. The town is located in the northeastern part of the country and in 1975 had a population of 6,427. From 1975 to 1981, 109 patients who suffered their first stroke were registered and were monitored for 5 years. The average annual incidence rates of stroke were 2.8 and 2.0 per 1,000 population in males and females, respectively. Mean age at stroke onset was 63-3 and 71.4 years in males and females, respectively (p<0.01). According to the clinical classification of stroke, 76 patients suffered cerebral infarction, 21 cerebral bleeding, and six subarachnoid hemorrhage; six strokes were unclassified. The survival rates were compared by sex, age, and clinical stroke type using Cox's proportional hazards model. The survival rate of female stroke patients was lower than that of males, but not significantly so. The survival rate of stroke patients >65 years old was significantly lower (p<0.01) than that of younger patients. Moreover, the survival rate of patients with cerebral bleeding was significantly lower (p<0.01) than that of patients with cerebral infarction. In the analysis of self-care among the survivors, performance of the activities of daily living in older patients indicated significantly less independence (/><0.01) in younger patients. Follow-up of new stroke cases showed that age and clinical stroke type were significantly associated with survival and that age was also related to disability of the survivors. (Stroke 1990-^1:72-77) M ortality due to cerebrovascular disease (stroke) in Japan is much higher than in other developed countries, and from 1951 to 1980 stroke was the leading cause of death in this country. The geographic pattern of stroke mortality in Japan varies from high in eastern to low in western Japan and high in more rural areas to low in more urban ones.1 Furthermore, in Akita Prefecture, stroke mortality has been among the highest in the 47 prefectures of Japan.The incidence of and mortality due to stroke are decreasing; however, the age at stroke onset and the percentage of infarction are increasing in Japan. Stroke is a major cause of disability and dementia in the elderly, and related problems in health care have become more important in recent years.The system of registering stroke patients was begun in 1963 in Ikawa Town, Akita Prefecture, Japan. The Address for reprints: Saburo Kojima, MD, Akita Prefectural Institute of Public Health, 6-6, Sensyu-Kubota-Machi, Akita, 010 Japan.Received July 15, 1988; accepted September 14, 1989. stroke incidence rates during [1975][1976][1977][1978][1979] and factors related to stroke onset have been reported. 2 Although a number of studies have described the natural history of stroke and the factors influencing survival, it is uncommon to find a study that combines data on survival and disability of stroke patients over a long period.The purpose of our study is to determine the differences in survival rates according to the variables sex, age at s...

“…[37][38][39] In addition, several studies have predicted stroke mortality by combining multiple factors. 5,8 For example, Fullerton et al 8 examined the ability of 21 factors to predict 6-month mortality for 206 consecutively admitted acute stroke patients.…”

Section: Discussionmentioning

confidence: 99%

Development of an Ischemic Stroke Survival Score

Williams

Jiang

2000

Background and Purpose-There has been substantial interest in identifying predictors of survival for stroke patients.Current instruments used for measuring stroke severity are confined to either neurological, functional, or disability measures. The purpose of this study was to develop a stroke survival score that combines instruments from different domains to better predict long-term survival. Methods-We took advantage of a particularly broad array of clinical and physiological variables collected during the Stroke Treatment with Ancrod Trial. Four hundred fifty-three patients completed a battery of instruments at day 7 after stroke and then were followed for 1 year. Results-Of the 453 patients, 53% were male, 77% were aged 65 years or older, and 89% were white. One hundred nine patients (24%) died during the study period. Age was a highly significant predictor of mortality (PϽ0.001), but there were no statistically significant differences in 12-month survival with respect to sex, race, or educational level.