Results of the seven-year prospective study of stroke patients.

Using the registry method, 1,538 stroke patients were detected in one district of Moscow between January 1, 1972, and December 31, 1974. Of the 965 patients who survived the acute stage of stroke (the first 3 weeks after onset), 941 (505 women and 436 men) were followed for the next 7 years. We analyzed incidence and types of recurrent strokes. During this 7-year follow-up, we recorded 32.1% of the patients as having recurrent strokes, most of which developed in the first 3 years and especially during the first year after the index stroke. The majority of recurrent strokes were of the same type as the index stroke and were localized in the same area of the brain. The cumulative mortality rates for the initial 1,538 patients were 37.3% dead by 3 weeks, 63.6% dead by 3 years, 72.1% dead by 5 years, and 76.5% dead by 7 years. In the first 3 months (excluding the first 3 weeks), most patients who died died of pulmonary thromboembolism. The mortality rate from recurrent strokes and pneumonia was higher than that from cardiovascular mortality. Transient ischemic attacks occurred in 49.5% of all patients and myocardial infarction in 16.4%. Functional prognosis was determined mainly by age, motor function, and concomitant diseases. After 1 year, 68.2% of the surviving patients were fully independent, while 81% of those surviving 7 years had reached this level. A significant number of patients were capable of returning to their previous work.