Ten-year survival after first-ever stroke in the Perth Community Stroke Study
Ten-year survival after first-ever stroke in the Perth Community Stroke Study
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DOI：
10.1161/01.str.0000082382.42061.ee
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发表时间：
2003-08-01
期刊：
影响因子：
8.3
通讯作者：
Anderson, C
中科院分区：
文献类型：
--
作者：
Hardie, K;Hankey, GJ;Anderson, C
背景和目的：很少有研究提供脑卒中后的长期预后信息。我们的目的是在西澳大利亚珀斯的一项基于人群的研究中确定首次中风患者10年以上的绝对和相对生存率。方法：从1989年2月开始的12个月时间里，所有疑似急性中风或短暂性脑缺血发作的个体都居住在西澳大利亚州珀斯的一个地理上明确的代表性地区，并根据标准化的诊断标准进行前瞻性登记和评估。首次明确中风的患者分别在指数事件发生后4个月、12个月、5年和10年进行前瞻性随访。结果：共有251例首次卒中患者登记，244例（97%）随访10年，其中197例（79%；95%可信区间[CI]， 74 ~ 84）死亡。死亡的主要原因是最初中风的直接影响（27%;95% CI, 21 - 33）和心血管疾病（26%;95% CI, 20 - 32）。在中风1年存活者中，年平均病死率为4.8%，是同年龄和性别的普通人群的2.3倍（95% CI, 1.9 - 2.7）。结论：五分之一的首次中风患者能活到10年。中风后1至10年的年平均病死率为4.8%，是一般人群预期的两倍。血管疾病是中风长期幸存者死亡的主要原因。
Background and Purpose-Very few studies have provided information regarding long-term prognosis after stroke. We aimed to determine the absolute and relative survival over 10 years among patients with first-ever stroke from a population-based study in Perth, Western Australia.Methods-For a 12-month period beginning February 1989, all individuals with a suspected acute stroke or transient ischemic attack who were resident in a geographically defined and representative region of Perth, Western Australia, were registered prospectively and assessed according to standardized diagnostic criteria. Patients with a definite first-ever stroke were followed up prospectively at 4 months, 12 months, 5 years, and 10 years after the index event.Results-A total of 251 patients with first-ever stroke were registered, and 244 (97%) were followed up at 10 years, by which time 197 (79%; 95% confidence interval [CI], 74 to 84) had died. The major causes of death were the direct effects of the initial stroke (27%; 95% CI, 21 to 33) and cardiovascular disease (26%; 95% CI, 20 to 32). Among 1-year survivors of stroke, the average annual case fatality was 4.8%, which was 2.3 (95% CI, 1.9 to 2.7) times greater than for the general population of the same age and sex.Conclusions-One in 5 patients with first-ever stroke survived to 10 years. The average annual case fatality was 4.8% between years 1 and 10 after stroke, which was twice that expected for the general population. Vascular disease is the major cause of death among long-term survivors of stroke.