PROGNOSIS FOR SURVIVAL AFTER AN INITIAL STROKE

Background and Purpose We studied prognosis for survival after an init ial stroke in 662 patients who survived at least 30 days after onset w hile taking into account age, sex, the number of neurological deficits from the initial stroke, stroke type, and five selected medical condi tions: hypertension, myocardial infarction, cardiac arrhythmia, diabet es mellitus, and history of transient ischemic attacks. Methods Al pat ients were enrolled between July 1, 1987, and August 1, 1989, and were followed regularly at about 6-month intervals until death or the end of the study (mean of 24 months). Results At 6 months, 90.8% of the 30 -day stroke survivors were still alive. At 1, 2, 3, and 4 years, the c umulative survival rates were 86.9%, 78.7%, 73.2%, and 72.0%, respecti vely. Older age and the number of neurological deficits at onset of in itial stroke increased risk of death. Compared with patients of the sa me age, sex, number of neurological deficits, and comorbidities, incre ased risk of death is present among those with myocardial infarction, cardiac arrhythmia, and diabetes mellitus. Hazard ratios were 1.7 (P=. 006), 1.5 (P=.023), and 1.4 (P=.059), respectively. Hypertension and t ransient ischemic attacks were not significantly associated with incre ased mortality. Conclusions This study clarifies prognosis for surviva l after an initial stroke by taking into account other confounding var iables that could also contribute to risk of death.