Gaëlle Romain1, Anne-Sophie Mariet2, Valérie Jooste1, Gauthier Duloquin3, Quentin Thomas3, Jérôme Durier3, Maurice Giroud3, Catherine Quantin2, Yannick Béjot4. 1. Digestive Cancer Registry of Burgundy, INSERM UMR 1231 EPICAD, University of Bourgogne-Franche Comté, University Hospital of Dijon, Dijon, France. 2. Biostatistics and Medical Information, University Hospital of Dijon, Inserm, CIC 1432 and Inserm UMR 1181, University of Bourgogne-Franche Comté, Dijon, France. 3. Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Bourgogne-Franche Comté, Dijon, France. 4. Dijon Stroke Registry, EA7460, Pathophysiology and Epidemiology of Cerebro-Cardiovascular diseases (PEC2), University Hospital of Dijon, University of Bourgogne-Franche Comté, Dijon, France, ybejot@yahoo.fr.
Abstract
OBJECTIVE: The aim of this study was to assess long-term survival after stroke and to compare survival profiles of patients according to stroke subtypes, age, and sex, using relative survival (RS) method. METHODS: All patients with a first-ever stroke were prospectively recorded in the population-based Dijon Stroke Registry from 1987 to 2016. RS is the survival that would be observed if stroke was the only cause of death. Ten-year RS was estimated using a flexible parametric model of the cumulative excess mortality rate, which was obtained by matching the observed all-cause mortality in the stroke cohort to the expected mortality in the general population. A separate model was fitted for each stroke subtypes, first fitted for each age and sex separately, and then adjusted for age and sex. RESULTS: In total, 5,259 patients (mean age 74.9 ± 14.3 years, 53% women) were recorded including 4,469 ischemic strokes (IS), 655 intracerebral hemorrhages (ICH), and 135 undetermined strokes. In IS patients, unadjusted RS was 82% at 1 year and decreased to 62% at 10 years. Adjusted RS showed a lower survival in older age groups (p < 0.001), but no difference between men and women (p = 0.119). In ICH patients, unadjusted RS was 56 and 42% at 1 and 10 years, respectively, with a lower adjusted survival in older age groups (p < 0.001), but no sex differences (p = 0.184). CONCLUSION: This study showed that RS after stroke is lower in older than in younger patients but without significant sex differences, and survival profiles differ according to stroke subtypes. Since RS allows a better estimation of stroke-related death than observed survival does, especially in old patients, such a method is adapted to provide reliable information when considering long-term outcome.
OBJECTIVE: The aim of this study was to assess long-term survival after stroke and to compare survival profiles of patients according to stroke subtypes, age, and sex, using relative survival (RS) method. METHODS: All patients with a first-ever stroke were prospectively recorded in the population-based Dijon Stroke Registry from 1987 to 2016. RS is the survival that would be observed if stroke was the only cause of death. Ten-year RS was estimated using a flexible parametric model of the cumulative excess mortality rate, which was obtained by matching the observed all-cause mortality in the stroke cohort to the expected mortality in the general population. A separate model was fitted for each stroke subtypes, first fitted for each age and sex separately, and then adjusted for age and sex. RESULTS: In total, 5,259 patients (mean age 74.9 ± 14.3 years, 53% women) were recorded including 4,469 ischemic strokes (IS), 655 intracerebral hemorrhages (ICH), and 135 undetermined strokes. In ISpatients, unadjusted RS was 82% at 1 year and decreased to 62% at 10 years. Adjusted RS showed a lower survival in older age groups (p < 0.001), but no difference between men and women (p = 0.119). In ICHpatients, unadjusted RS was 56 and 42% at 1 and 10 years, respectively, with a lower adjusted survival in older age groups (p < 0.001), but no sex differences (p = 0.184). CONCLUSION: This study showed that RS after strokeis lower in older than in younger patients but without significant sex differences, and survival profiles differ according to stroke subtypes. Since RS allows a better estimation of stroke-related death than observed survival does, especially in old patients, such a method is adapted to provide reliable information when considering long-term outcome.
Authors: Laura Ramiro; Laura Abraira; Manuel Quintana; Paula García-Rodríguez; Estevo Santamarina; Jose Álvarez-Sabín; Josep Zaragoza; María Hernández-Pérez; Xavier Ustrell; Blanca Lara; Mikel Terceño; Alejandro Bustamante; Joan Montaner Journal: Life (Basel) Date: 2021-02-10
Authors: Wang Ningning; Hu Ying; Lin Shudong; Zhang Zhilong; Cai Qibo; Deng Yuting; Zhang Hao; Wu Nan; Qiu Changchun; Yang Xiujing; Jin Ming; Li Jingping Journal: Medicine (Baltimore) Date: 2022-09-23 Impact factor: 1.817