The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project.

Bamford, J.; Dennis, Martin; Sandercock, Peter; Burn, John; Warlow, Charles

doi:10.1136/jnnp.53.10.824

Cited by 284 publications

(170 citation statements)

References 28 publications

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“…In Brazil, the results seem to vary slightly, depending on other factors such as the sample size and the region where the study was conducted, varying from 5 to 24.6% 4,11,12 . These data confirm a global trend of a significant reduction in the death rates related to disease 13 . In Oxfordshire, United Kingdom, during the periods between 1981 and 1984 and between 2002 and 2004, the death rates decreased by 20 to 40%.…”

Section: Discussionsupporting

confidence: 76%

Infectious disease is the most common cause of death among stroke patients: two-years of follow-up

Machado

Brucki

Nogueira

et al. 2013

Arq. Neuro-Psiquiatr.

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Stroke represents the second common cause of death in adults. Objective It was to evaluate the incidence and causes of mortality after 30 days in a group of patients with an atherothrombotic ischemic stroke who were followed-up for a period of up to two years. Methods We analyzed retrospectively the medical records of patients with ischemic stroke, who did not undergo thrombolysis, of the Santa Marcelina Hospital. We applied a research protocol to obtain information about risk factors and the etiology of death. Results They were followed 337: mean age was 66.6 years (SD 9.05) and 43.9% were females. The mortality rate was 11.9% with most deaths (37.5%) occurring due to infectious causes. The age was correlated with the risk of death, which was five times higher in patients older than 80. Conclusion The most important cause of death after 30 days was infectious disease, and advanced age was predictor of mortality among patients with an atherothrombotic stroke etiology.

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Section: Discussionsupporting

confidence: 76%

Infectious disease is the most common cause of death among stroke patients: two-years of follow-up

Machado

Brucki

Nogueira

et al. 2013

Arq. Neuro-Psiquiatr.

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“…Patients with ICH have a higher early case fatality than do those with ISs. In CT-based studies, patients with ICH showed shortterm case fatality rates between 35% and 55% (Broderick et al, 1989;Bamford et al, 1990;Rosenow et al, 1997). However, at 2-year follow-up, the case fatality increased by only 3.4% to 38% in one study (Rosenow et al, 1997).…”

Section: The Influence Of Differences Between Patient Groupsmentioning

confidence: 99%

Status Epilepticus after Stroke Is Associated with Increased Long‐term Case Fatality

Knake¹,

Rochon

Fleischer³

et al. 2006

Epilepsia

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Summary:Purpose: The aim of this study was to determine the long-term case fatality of patients with a first episode of status epilepticus (SE group) of cerebrovascular etiology, as compared with that in acute stroke patients without SE (AS group).Methods: Patients with SE who had been prospectively admitted to an epidemiologic study were retrospectively compared with a cohort of patients from the local stroke registry. The main outcome end point was overall survival. Survival curves were generated according to the Kaplan-Meier method and compared by using the log-rank test. An extended Cox model was used to examine the impact of patient group on the risk of death. Covariates considered potential confounders included age at diagnosis, sex, type of stroke, affected hemisphere, and localization of lesions.Results: Of 166 patients who entered the study, 93 patients were in the SE group, and 73 patients were in the AS group; 53 SE patients and 35 AS patients died during the study. Patient group (SE vs. AS) showed no significant impact on survival (p = 0.0832) in univariate analysis. In contrast, the results from a multivariable analysis suggest that after 6 months, patients with SE were at about twice the risk of death as were patients with AS [hazard ratio of 2.12 with 95% confidence interval, 1.04-4.32, p = 0.0392].Conclusions: The occurrence of SE in patients with cerebrovascular disease indicates a high risk of death within 3 years. In contrast, the case fatality risk attributable to recurrent status or seizures is lower. Key Words: Long-term mortality-Case fatality-Risk factors-Causes of death-Status epilepticus.Status epilepticus (SE) is a major neurologic emergency with an incidence of ∼20/100,000 for the white population in industrialized countries. Several studies have described determinants of mortality among patients with SE (Lowenstein and Alldredge, 1998). Most of these studies have investigated mortality after SE up to a maximum follow-up period of <1 year, mostly up to 30 days or to discharge from hospital (Aminoff and Simon, 1980;Barry and Hauser, 1993;Scholtes et al., 1994;Towne et al., 1994;Logroscino et al., 1997).SE was associated with short-term mortality rates of ∼20% (Hauser, 1990;DeLorenzo et al., 1995;Logroscino et al., 1997;Lowenstein and Alldredge, 1998;Knake et al., 2001;Rosenow et al., 2002;Wu et al., 2002). Patient age at diagnosis, etiology of SE (especially anoxia), severity of the underlying disease. and duration of SE were main predictors of increased short-term mortality (Hauser, 1990;Lowenstein and Alldredge, 1998;Wu et al., 2002 In contrast, available reports examining long-term mortality after SE are sparse. Only one recent study systematically analyzed mortality at more than 10 years after the first episode of SE and found an increased long-term mortality of 43%, significantly associated with older age, status duration >24 h, acute symptomatic etiology including stroke, and myoclonic SE caused by hypoxic brain injury (Logroscino et al., 2002).The authors concluded that SE alone...

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“…The frequency of infection in patients with acute stroke has been the subject of numerous clinical studies. Owing to different designs, patient selection criteria, diagnostic criteria, timing of assessment, and duration of follow-up, the results vary considerably, with a reported incidence of infection up to 90 % [9][10][11][12][13]. Almost all studies described pneumonia as the most frequent type of infection after stroke, followed by urinary tract infection [6].…”

Section: Rationale Behind Prophylactic Antibiotic Therapy In Strokementioning

confidence: 99%

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

Schwarz

2016

Neurotherapeutics

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Infections, in particular pneumonia, are common complications in patients with acute stroke and are associated with a less favorable neurologic and functional outcome. Patients with severe stroke and dysphagia are at highest risk of infection. Experimental and clinical data suggest stroke-induced immunodeficiency as a major factor contributing to the high incidence of infection after stroke. Preclinical studies support the potential benefit of preventive antibiotic therapy in acute stroke for lowering the incidence of infection and improving clinical outcome. Several smaller clinical trials on preventive antibiotic therapy in patients with stroke conducted during the last 10 years yielded inconclusive results. Recently, 2 large, open-label, controlled trials failed to demonstrate an improved clinical outcome after preventive antibiotic therapy in patients with acute stroke treated in specialized stroke units. In the BPreventive Antibiotics in Stroke Study^, antibiotic therapy lowered the rate of infection but did not influence outcome. In the STROKE-INF study, performed in patients with dysphagia after stroke, antibiotic therapy did not lower the incidence of pneumonia and had no prognostic significance. At present, preventive antibiotic therapy cannot be recommended as a therapeutic option for acute stroke.

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The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project.

Cited by 284 publications

References 28 publications

Infectious disease is the most common cause of death among stroke patients: two-years of follow-up

Infectious disease is the most common cause of death among stroke patients: two-years of follow-up

Status Epilepticus after Stroke Is Associated with Increased Long‐term Case Fatality

Prophylactic Antibiotic Therapy for Preventing Poststroke Infection

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