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Functional outcome 3 months after stroke predicts long-term survival

Eriksson, Marie; Norrving, Bo LU ; Terent, Andreas and Stegmayr, Birgitta (2008) In Cerebrovascular Diseases 25(5). p.423-429
Abstract
Background: When reporting stroke survival and prognostic factors with a possible effect on outcome, the starting point for the observation of a clinical cohort usually is the onset of stroke or the acute admission of a patient. Thus, acute and early mortality inflict prognosis on long-term outcome. In order to give a more robust analysis of long-term survival after the acute period we chose to start our observation with 3-month survivors. Methods: We used data from Riks-Stroke, the Swedish quality register for stroke care, together with survival information from the Swedish population register to explore the influence of disability level 3 months after stroke on long-term survival. The main analysis included 15,959 stroke patients,... (More)
Background: When reporting stroke survival and prognostic factors with a possible effect on outcome, the starting point for the observation of a clinical cohort usually is the onset of stroke or the acute admission of a patient. Thus, acute and early mortality inflict prognosis on long-term outcome. In order to give a more robust analysis of long-term survival after the acute period we chose to start our observation with 3-month survivors. Methods: We used data from Riks-Stroke, the Swedish quality register for stroke care, together with survival information from the Swedish population register to explore the influence of disability level 3 months after stroke on long-term survival. The main analysis included 15,959 stroke patients, registered during 2001-2002, who had been independent in primary activities of daily living before stroke, had suffered an ischaemic or a haemorrhagic stroke and reported no previous stroke. Results: Impaired functional outcome after stroke was an independent predictor of poor survival. Patients with modified Rankin scale (mRS) grades 3, 4 and 5 had hazard ratios of 1.7, 2.5 and 3.8, respectively, as compared with patients with lower mRS grades. In addition to high mRS, male sex, high age, diabetes, smoking, hypertension therapy at stroke onset, atrial fibrillation and depressed mood were also recognized as significant predictors of poor survival using a multiple Cox regression model. Conclusion: The influence of disability on survival is stronger than that of several other well-known prognostic factors. This finding indicates that any intervention in the acute phase that may improve functional status at 3 months will also have favourable secondary effects on survival in the long term. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
stroke, registries, functional recovery, stroke outcome, outcome assessment
in
Cerebrovascular Diseases
volume
25
issue
5
pages
423 - 429
publisher
Karger
external identifiers
  • wos:000256571200007
  • scopus:44449156444
ISSN
1421-9786
DOI
10.1159/000121343
language
English
LU publication?
yes
id
d587a1f1-280c-4a8f-9920-2f086a905e6c (old id 1201445)
date added to LUP
2008-09-15 10:16:47
date last changed
2017-10-22 03:48:32
@article{d587a1f1-280c-4a8f-9920-2f086a905e6c,
  abstract     = {Background: When reporting stroke survival and prognostic factors with a possible effect on outcome, the starting point for the observation of a clinical cohort usually is the onset of stroke or the acute admission of a patient. Thus, acute and early mortality inflict prognosis on long-term outcome. In order to give a more robust analysis of long-term survival after the acute period we chose to start our observation with 3-month survivors. Methods: We used data from Riks-Stroke, the Swedish quality register for stroke care, together with survival information from the Swedish population register to explore the influence of disability level 3 months after stroke on long-term survival. The main analysis included 15,959 stroke patients, registered during 2001-2002, who had been independent in primary activities of daily living before stroke, had suffered an ischaemic or a haemorrhagic stroke and reported no previous stroke. Results: Impaired functional outcome after stroke was an independent predictor of poor survival. Patients with modified Rankin scale (mRS) grades 3, 4 and 5 had hazard ratios of 1.7, 2.5 and 3.8, respectively, as compared with patients with lower mRS grades. In addition to high mRS, male sex, high age, diabetes, smoking, hypertension therapy at stroke onset, atrial fibrillation and depressed mood were also recognized as significant predictors of poor survival using a multiple Cox regression model. Conclusion: The influence of disability on survival is stronger than that of several other well-known prognostic factors. This finding indicates that any intervention in the acute phase that may improve functional status at 3 months will also have favourable secondary effects on survival in the long term.},
  author       = {Eriksson, Marie and Norrving, Bo and Terent, Andreas and Stegmayr, Birgitta},
  issn         = {1421-9786},
  keyword      = {stroke,registries,functional recovery,stroke outcome,outcome assessment},
  language     = {eng},
  number       = {5},
  pages        = {423--429},
  publisher    = {Karger},
  series       = {Cerebrovascular Diseases},
  title        = {Functional outcome 3 months after stroke predicts long-term survival},
  url          = {http://dx.doi.org/10.1159/000121343},
  volume       = {25},
  year         = {2008},
}