BACKGROUND AND PURPOSE: The purpose of this study was to define predictors of poor outcome after a first-ever stroke. We studied risk factors and stroke severity at baseline in relationship to death, dependency, and stroke recurrence within a year after the event. METHODS: The study included a community-based cohort of first-ever stroke patients. Subarachnoid hemorrhage was not included. All patients (n=377) were subjected to investigations regarding risk factors. Stroke severity was evaluated with the National Institutes of Health Stroke Scale, and dependency was defined according to the modified Rankin Scale. Multivariate regression models were used to analyze predictors of survival, dependency, and stroke recurrence. The following independent variables were used: age, sex, cohabitation status, cigarette smoking, dementia, hypertension, ischemic heart disease, heart failure, atrial fibrillation, diabetes mellitus, transitory ischemic attack, peripheral atherosclerosis, and stroke severity. RESULTS: The 1-year mortality was 33%. After 1 year, 37% of the survivors were dependent; 9% of survivors had a recurrent stroke within a year. Dementia, age, stroke severity, and atrial fibrillation were associated with death within a year. Dependency was associated with age, stroke severity, and heart failure. Stroke recurrence was predicted by age and dementia. CONCLUSIONS: In addition to age and stroke severity, heart diseases and dementia before the stroke seem to have an impact on mortality and recurrence after 1 year. Finding and, when possible, treating these prestroke conditions may affect stroke morbidity and mortality favorably.
BACKGROUND AND PURPOSE: The purpose of this study was to define predictors of poor outcome after a first-ever stroke. We studied risk factors and stroke severity at baseline in relationship to death, dependency, and stroke recurrence within a year after the event. METHODS: The study included a community-based cohort of first-ever strokepatients. Subarachnoid hemorrhage was not included. All patients (n=377) were subjected to investigations regarding risk factors. Stroke severity was evaluated with the National Institutes of Health Stroke Scale, and dependency was defined according to the modified Rankin Scale. Multivariate regression models were used to analyze predictors of survival, dependency, and stroke recurrence. The following independent variables were used: age, sex, cohabitation status, cigarette smoking, dementia, hypertension, ischemic heart disease, heart failure, atrial fibrillation, diabetes mellitus, transitory ischemic attack, peripheral atherosclerosis, and stroke severity. RESULTS: The 1-year mortality was 33%. After 1 year, 37% of the survivors were dependent; 9% of survivors had a recurrent stroke within a year. Dementia, age, stroke severity, and atrial fibrillation were associated with death within a year. Dependency was associated with age, stroke severity, and heart failure. Stroke recurrence was predicted by age and dementia. CONCLUSIONS: In addition to age and stroke severity, heart diseases and dementia before the stroke seem to have an impact on mortality and recurrence after 1 year. Finding and, when possible, treating these prestroke conditions may affect stroke morbidity and mortality favorably.
Authors: Deborah A Levine; James M Walter; Sudeep J Karve; Lesli E Skolarus; Steven R Levine; Kristine A Mulhorn Journal: J Stroke Cerebrovasc Dis Date: 2014-01-15 Impact factor: 2.136
Authors: M S Mouradian; A Senthilselvan; G Jickling; J A McCombe; D J Emery; N Dean; A Shuaib Journal: J Neurol Neurosurg Psychiatry Date: 2005-09 Impact factor: 10.154
Authors: Gina L Evans-Hudnall; Melinda A Stanley; Allison N Clark; Amber L Bush; Ken Resnicow; Yu Liu; Joseph S Kass; Angelle M Sander Journal: J Behav Med Date: 2012-12-08
Authors: Patrick M Pullicino; Leslie A McClure; Virginia G Wadley; Ali Ahmed; Virginia J Howard; George Howard; Monika M Safford Journal: Stroke Date: 2009-10-15 Impact factor: 7.914
Authors: James Lewsey; Pardeep S Jhund; Michelle Gillies; Jim W T Chalmers; Adam Redpath; Andrew Briggs; Matthew Walters; Peter Langhorne; Simon Capewell; John J V McMurray; Kate MacIntyre Journal: BMC Med Date: 2010-04-09 Impact factor: 8.775