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Stroke in Lund-Orup, Sweden: improved long-term survival among elderly stroke patients.

Hallström, Björn LU ; Norrving, Bo LU and Lindgren, Arne LU (2002) In Stroke: a journal of cerebral circulation 33(6). p.1624-1629
Abstract
BACKGROUND AND PURPOSE: Several studies report declining early stroke case fatality, but the findings are not consistent across geographic areas. Corresponding changes in long-term survival are less well documented. We recently reported increased stroke incidence among patients aged <75 years and stable incidence among older persons. We now report temporal trends for early and late case fatality among patients with stroke onset during 1983-1985 and 1993- 1995. METHODS: Patients living within the Lund-Orup, Sweden, hospital district and fulfilling the diagnostic criteria for first-ever stroke during 1983-1985 (n=998) and 1993-1995 (n=1318) were followed up concerning survival status at 28 days, 1 year, and 3 years. Age and sex... (More)
BACKGROUND AND PURPOSE: Several studies report declining early stroke case fatality, but the findings are not consistent across geographic areas. Corresponding changes in long-term survival are less well documented. We recently reported increased stroke incidence among patients aged <75 years and stable incidence among older persons. We now report temporal trends for early and late case fatality among patients with stroke onset during 1983-1985 and 1993- 1995. METHODS: Patients living within the Lund-Orup, Sweden, hospital district and fulfilling the diagnostic criteria for first-ever stroke during 1983-1985 (n=998) and 1993-1995 (n=1318) were followed up concerning survival status at 28 days, 1 year, and 3 years. Age and sex adjustments were performed. The possible influence of Oxfordshire Community Stroke Project (OCSP) stroke subtypes on survival was also analyzed. RESULTS: Overall survival improved between the study periods (Cox proportional hazards regression: hazard ratio, 0.84; 95% confidence limits, 0.75 to 0.94; P=0.0019). The 28-day case fatality was 15% for stroke patients from both study periods. One-year case fatality was 31% for 1983-1985 patients and 27% for 1993-1995 patients. The corresponding figures at 3 years were 44% and 40%, respectively. In the group aged <75 years, there were no significant changes in overall survival, but survival improved significantly among patients aged > or = 75 years beyond 28 days after stroke onset. OCSP stroke subtype was an independent predictor of death (P<0.0001). CONCLUSIONS: The recently observed increase in stroke incidence among patients aged <75 years was not accompanied by changing survival in that age group. However, among patients aged > or =75 years, survival improved beyond 28 days after stroke. The causes of this change in survival are unknown but may be related to improved long-term care of elderly stroke patients. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Proportional Hazards Models, Male, Middle Age, Human, Follow-Up Studies, Age Distribution, Aged, 80 and over, Cerebrovascular Accident : mortality, Cerebrovascular Accident : classification, Survival Rate, Survivors : statistics & numerical data, Sweden : epidemiology, Female, Regression Analysis
in
Stroke: a journal of cerebral circulation
volume
33
issue
6
pages
1624 - 1629
publisher
American Heart Association
external identifiers
  • pmid:12053002
  • wos:000176164300046
  • scopus:0036281496
ISSN
1524-4628
DOI
10.1161/01.STR.0000017222.48968.6E
language
English
LU publication?
yes
id
c6dff863-bc74-4bf3-b005-15be95309cc4 (old id 108690)
alternative location
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12053002&dopt=Abstract
date added to LUP
2007-07-06 09:35:53
date last changed
2017-07-09 04:26:33
@article{c6dff863-bc74-4bf3-b005-15be95309cc4,
  abstract     = {BACKGROUND AND PURPOSE: Several studies report declining early stroke case fatality, but the findings are not consistent across geographic areas. Corresponding changes in long-term survival are less well documented. We recently reported increased stroke incidence among patients aged &lt;75 years and stable incidence among older persons. We now report temporal trends for early and late case fatality among patients with stroke onset during 1983-1985 and 1993- 1995. METHODS: Patients living within the Lund-Orup, Sweden, hospital district and fulfilling the diagnostic criteria for first-ever stroke during 1983-1985 (n=998) and 1993-1995 (n=1318) were followed up concerning survival status at 28 days, 1 year, and 3 years. Age and sex adjustments were performed. The possible influence of Oxfordshire Community Stroke Project (OCSP) stroke subtypes on survival was also analyzed. RESULTS: Overall survival improved between the study periods (Cox proportional hazards regression: hazard ratio, 0.84; 95% confidence limits, 0.75 to 0.94; P=0.0019). The 28-day case fatality was 15% for stroke patients from both study periods. One-year case fatality was 31% for 1983-1985 patients and 27% for 1993-1995 patients. The corresponding figures at 3 years were 44% and 40%, respectively. In the group aged &lt;75 years, there were no significant changes in overall survival, but survival improved significantly among patients aged &gt; or = 75 years beyond 28 days after stroke onset. OCSP stroke subtype was an independent predictor of death (P&lt;0.0001). CONCLUSIONS: The recently observed increase in stroke incidence among patients aged &lt;75 years was not accompanied by changing survival in that age group. However, among patients aged &gt; or =75 years, survival improved beyond 28 days after stroke. The causes of this change in survival are unknown but may be related to improved long-term care of elderly stroke patients.},
  author       = {Hallström, Björn and Norrving, Bo and Lindgren, Arne},
  issn         = {1524-4628},
  keyword      = {Proportional Hazards Models,Male,Middle Age,Human,Follow-Up Studies,Age Distribution,Aged,80 and over,Cerebrovascular Accident : mortality,Cerebrovascular Accident : classification,Survival Rate,Survivors : statistics & numerical data,Sweden : epidemiology,Female,Regression Analysis},
  language     = {eng},
  number       = {6},
  pages        = {1624--1629},
  publisher    = {American Heart Association},
  series       = { Stroke: a journal of cerebral circulation},
  title        = {Stroke in Lund-Orup, Sweden: improved long-term survival among elderly stroke patients.},
  url          = {http://dx.doi.org/10.1161/01.STR.0000017222.48968.6E},
  volume       = {33},
  year         = {2002},
}