Ten-Year Survival After First-Ever Stroke in the Perth Community Stroke Study

Abstract

Background and Purpose-Very few studies have provided information regarding long-term prognosis after stroke. We aimed to determine the absolute and relative survival over 10 years among patients with first-ever stroke from a population-based study in Perth, Western Australia. Methods-For a 12-month period beginning February 1989, all individuals with a suspected acute stroke or transient ischemic attack who were resident in a geographically defined and representative region of Perth, Western Australia, were registered prospectively and assessed according to standardized diagnostic criteria. Patients with a definite first-ever stroke were followed up prospectively at 4 months, 12 months, 5 years, and 10 years after the index event. Results-A total of 251 patients with first-ever stroke were registered, and 244 (97%) were followed up at 10 years, by which time 197 (79%; 95% confidence interval [CI], 74 to 84) had died. The major causes of death were the direct effects of the initial stroke (27%; 95% CI, 21 to 33) and cardiovascular disease (26%; 95% CI, 20 to 32). Among 1-year survivors of stroke, the average annual case fatality was 4.8%, which was 2.3 (95% CI, 1.9 to 2.7) times greater than for the general population of the same age and sex. Conclusions-One in 5 patients with first-ever stroke survived to 10 years. The average annual case fatality was 4.8% between years 1 and 10 after stroke, which was twice that expected for the general population. Vascular disease is the major cause of death among long-term survivors of stroke.

Effects of aquatic exercise on depression and anxiety in ischemic stroke subjects

“…The results corroborate other studies that indicate that stroke is a severe disease, with high morta- lity and high rates of recidivism [35][36][37][38][39], showing that sequels tend to be definitive [40][41][42]. The same type of results could be expected if the subjects had used drugs for this purpose.…”

An assessment of the cost-effectiveness of magnetic resonance, including diffusion-weighted imaging, in patients with transient ischaemic attack and minor stroke: a systematic review, meta-analysis and economic evaluation

“…8,153,164,308,315,[318][319][320][321][322][323][324][325] Data on the proportion of patients who would be alive and independent after stroke by severity and time after index stroke were obtained from multiple sources (see Table 61, boxes 42-49).…”

“…65 Ten-year risk of death was 42% (95% CI 41% to 45%) and of a first vascular event was 44% (95% CI 42% to 46%) and similar factors predicted vascular event as vascular death (non-fatal stroke 480/1741 total events, non-fatal MI 185/1741, fatal stroke 139/1741, fatal MI 138/1741). 65 The Perth Community Stroke Study (PCSS) 318,319 was a population-based study in Western Australia and also reported long-term survival after first-ever stroke. The 10-year cumulative risk of death was 79% (95% CI 74% to 84%).…”

Stroke incidence and prevalence in Europe: a review of available data

“…Some of the excess deaths in long-term stroke survivors are because of heart disease and other causes. Different studies, all from developed countries, indicate that between one-third and half of all stroke patients die from stroke [9][10][11][12][13][14]. It was assumed that the proportion of long-term stroke survivors who die from stroke is constant in all countries.…”