SURVIVAL AND RECURRENCE FOLLOWING STROKE - THE FRAMINGHAM-STUDY
SURVIVAL AND RECURRENCE FOLLOWING STROKE - THE FRAMINGHAM-STUDY
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DOI：
10.1161/01.str.13.3.290
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发表时间：
1982-01-01
期刊：
影响因子：
8.3
通讯作者：
MCNAMARA, PM
中科院分区：
文献类型：
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作者：
SACCO, RL;WOLF, PA;MCNAMARA, PM
在5184名普通人群样本中，对中风后的存活率和复发进行了前瞻性评估，每两年随访一次，为期26年。最初的中风发生在198名男性和196名女性。据报道，84秒和27次中风，223人死亡。首次卒中30天病死率：脑梗塞15%(33/222)，脑血栓16%(10/63)，蛛网膜下腔出血46%(18/39)，脑出血82%(14/17)。中风前心脏病(冠心病和/或充血性心力衰竭)和首次中风前的高血压使脑梗塞的累积5年存活率降低，男性为0.85至0.35，女性为0.70至0.56。仅高血压一项就将男性的存活率从0.85降低到0.51，但在女性中并非如此。复发的主要类型与最初的中风相同。男性脑梗塞累积5年复发率为0.42，几乎是女性的两倍。通过排除高血压患者和合并心脏病和高血压的患者，降低了发病率。卒中后死亡或复发的风险很大，并且深受性别、心脏合并症和首次事件发生前存在的高血压的影响。
Survival and recurrences after stroke were assessed prospectively in a general population sample of 5184 subjects followed biennially for 26 yr. Initial strokes occurred in 198 men and 196 women. There were 84-second and 27 third strokes and 223 deaths reported. Thirty-day fatality rates for initial strokes were as follows: 15% (33/222) for brain infarction, 16% (10/63) for cerebral embolus, 46% (18/39) for subarachnoid hemorrhage, and 82% (14/17) for intracerebral hemorrhage. Cumulative, age-adjusted 5-yr survival rates for brain infarction were reduced by prestroke cardiac disease (coronary heart disease and/or congestive heart failure) and hypertension prior to initial stroke from 0.85 to 0.35 in men and 0.70 to 0.56 in women. Hypertension alone reduced survival from 0.85 to 0.51 in men, but not in women. Recurrences were primarily of the same type as the initial stroke. Cumulative 5-yr recurrence rate for brain infarction was 0.42 for men, almost double that for women. Rates were reduced by excluding hypertensives and those with combined cardiac comorbidity and hypertension. Risk of death or recurrence after stroke is substantial and profoundly influenced by sex and by cardiac comorbidity and hypertension present prior to the initial event.