Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, September 5, 2013

Five-Year Survival After First-Ever Stroke and Related Prognostic Factors in the Perth Community Stroke Study

Well, I beat the odds since I'm now 7 years into it.
Talk to your doctor to make sure there is a defined, actionable plan to beat these statistics. 
http://stroke.ahajournals.org/content/31/9/2080.long

  1. Edward G. Stewart-Wynne, MBChB, FCP(SA), FRACP
+ Author Affiliations
  1. From the Stroke Unit, Department of Neurology, Royal Perth Hospital (Western Australia) (G.J.H., E.G.S-W.); Departments of Medicine (G.J.H.), Public Health (K.J., R.J.B., S.F.), and Psychiatry and Behavioral Science (P.W.B.), University of Western Australia, Perth; and Faculty of Medicine and Health Science, University of Auckland (New Zealand) (C.S.A.).
  1. Correspondence to Dr Graeme J. Hankey, Stroke Unit, Department of Neurology, Royal Perth Hospital, GPO Box X2213, Perth, Western Australia 6001. E-mail gjhankey@cyllene.uwa.edu.au

Abstract

Background and Purpose—Few community-based studies have examined the long-term survival and prognostic factors for death within 5 years after an acute first-ever stroke. This study aimed to determine the absolute and relative survival and the independent baseline prognostic factors for death over the next 5 years among all individuals and among 30-day survivors after a first-ever stroke in a population of Perth, Western Australia.
Methods—Between February 1989 and August 1990, all individuals with a suspected acute stroke or transient ischemic attack of the brain who were resident in a geographically defined region of Perth, Western Australia, with a population of 138 708 people, were registered prospectively and assessed according to standardized diagnostic criteria. Patients were followed up prospectively at 4 months, 12 months, and 5 years after the index event.
Results—Three hundred seventy patients with first-ever stroke were registered, and 362 (98%) were followed up at 5 years, by which time 210 (58%) had died. In the first year after stroke the risk of death was 36.5% (95% CI, 31.5% to 41.4%), which was 10-fold (95% CI, 8.3% to 11.7%) higher than that expected among the general population of the same age and sex. The most common cause of death was the index stroke (64%). Between 1 and 5 years after stroke, the annual risk of death was approximately 10% per year, which was approximately 2-fold greater than expected, and the most common cause of death was cardiovascular disease (41%). The independent baseline factors among 30-day survivors that predicted death over 5 years were intermittent claudication (hazard ratio [HR], 1.9; 95% CI, 1.2 to 2.9), urinary incontinence (HR, 2.0; 95% CI, 1.3 to 3.0), previous transient ischemic attack (HR, 2.4; 95% CI, 1.4 to 4.1), and prestroke Barthel Index <20/20 (HR, 2.0; 95% CI, 1.2 to 3.2).
Conclusions—One-year survivors of first-ever stroke continue to die over the next 4 years at a rate of approximately 10% per year, which is twice the rate expected among the general population of the same age and sex. The most common cause of death is cardiovascular disease. Long-term survival after stroke may be improved by early, active, and sustained implementation of effective strategies for preventing subsequent cardiovascular events.

Outcome at 5 Years

Absolute Risks for All Patients

Table 1 and Figure 1 show that the 5-year cumulative risk of death was 60.1% (95% CI, 54.7% to 65.5%). The risk of death was greatest in the first year after stroke (36.5%; 95% CI, 31.5% to 41.4%) and particularly in the first 30 days after stroke (23.5%; 95% CI, 19.1% to 27.9%). Beyond the first year, approximately 10% of survivors continued to die each year. 



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