Tuesday, January 29, 2019

Long-Term Survival and Function After Stroke - Sweden

Wouldn't you think that the stroke associations for each country would have this specific information? Then they could use the causes of death and disability as starting points for RFPs to researchers to solve and prevent those problems. This is blindingly simple to understand and implement. But will never occur since two functioning neurons don't exist in our stroke associations. 

Long-Term Survival and Function After Stroke - Sweden

A Longitudinal Observational Study From the Swedish Stroke Register
Originally publishedhttps://doi.org/10.1161/STROKEAHA.118.022913Stroke. 2018;50:53–61

Background and Purpose—

Longitudinal long-term prognostic data after stroke based on large cohorts are sparse. We report recent survival and functional outcome data on ischemic stroke (IS) and intracerebral hemorrhage (ICH) for up to 5 years poststroke from the Swedish Stroke Register (Riksstroke).

Methods—

Beyond Riksstroke’s regular follow-up surveys at 3 and 12 months, additional surveys were conducted in 2016 on 2 one-year cohorts with stroke 3 and 5 years earlier. Functional dependency was defined as modified Rankin Scale ≥3. Mortality data of the original cohorts were obtained from the Swedish Causes of Death Register. Multiple imputation was used to estimate functional status in nonresponders.

Results—

The study included 22 929 patients, 87.5% with IS and 12.5% with ICH. Loss to follow-up in the 4 surveys was 12.8% to 21.2%. Thirty-day mortality was higher for ICH than for IS (30.7% versus 11.1%; P<0.01), whereas for 30-day survivors, 5-year mortality did not differ significantly (P=0.858). Functional outcome was less favorable for ICH at all follow-up points. At 5 years, poor outcome (death or dependency) was 79% in ICH and 70.6% in IS (including imputed data; P<0.01). Favorable outcome was less common with increasing age and in patients with prestroke functional dependency.

Conclusions—

Despite advances in stroke care, long-term prognosis remains a cause for concern. At 5 years after stroke over 2 in 3 patients with IS, and over 3 in 4 patients with ICH, were dead or dependent. We present robust long-term prognostic data to serve as a reference for further development of healthcare and research in stroke.

Footnotes

Presented in part at the European Stroke Organisation Conference, Gothenburg, Sweden, May 16–18, 2018.
The online-only Data Supplement is available with this article at https://www.ahajournals.org/doi/suppl/10.1161/STROKEAHA.118.022913.
Correspondence to Stefan Sennfält, MD, Neurologimottagningen, Skånes universitetssjukhus, Region Skåne, Getingevägen 4, 222 41 Lund. Email


No comments:

Post a Comment