SURVIVAL AND RECURRENCE AFTER FIRST CEREBRAL INFARCTION - A POPULATION-BASED STUDY IN ROCHESTER, MINNESOTA, 1975 THROUGH 1989

We used the Kaplan-Meier product limit method to estimate rates and Co x proportional hazards regression analysis with bootstrap validation t o model significant independent predictors of and temporal trends in s urvival and recurrent stroke among 1,111 residents of Rochester, MN, w ho had a first cerebral infarction from 1975 through 1989. The risk of death after first cerebral infarction was 7% +/- 0.7% at 7 days, 14% +/- 1.0% at; 30 days, 27% +/- 1.3% at 1 year, and 53% +/- 1.5% at 5 ye ars. Independent risk factors for death after first cerebral infarctio n were age (p < 0.0001), congestive heart failure (p < 0.0001), persis tent atrial fibrillation (p < 0.0001), recurrent stroke (p < 0.0001), and ischemic heart disease (p < 0.0001 for age less than or equal to 7 0, p > 0.05 for age >70). The risk of recurrent stroke after first cer ebral infarction was 2% +/- 0.4% at 7 days, 4% +/- 0.6% at 30 days, 12 % +/- 1.1% at 1 year, and 29% +/- 1.7% at 5 years. Age (p = 0.0002) an d diabetes mellitus (p = 0.0004) were the only significant independent predictors of recurrent stroke. Neither the year nor the quinquennium of the first cerebral infarction was a significant determinant of sur vival or recurrence. The temporal trend toward improving survival afte r first cerebral infarction documented in Rochester, MN, in the decade s before 1975 has ended.