Five-year survival after first-ever ischaemic stroke is worse in total anterior circulation infarcts: the SINPAC cohort

• Published in: Cerebrovascular diseases (Basel, Switzerland) Vol. 27; no. 1; p. 29
• Main Author: Reggiani, M
• Format: Journal Article
• Language: English
• Published: Switzerland 2009
• Subjects: Aged; Aged, 80 and over; Brain Ischemia - complications; Brain Ischemia - mortality; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - mortality; Cohort Studies; Female; Humans; Infarction, Anterior Cerebral Artery - mortality; Length of Stay; Male; Middle Aged; Predictive Value of Tests; Prognosis; Risk Factors; Stroke - etiology; Stroke - mortality; Survival Analysis
• ISSN: 1421-9786
• DOI: 10.1159/000172631

Few studies have addressed predictors of long-term mortality after first-ever ischaemic stroke.
We prospectively collected data on 361 consecutive patients admitted to 18 neurology departments in Italy for a first-ever ischaemic stroke in 1999, categorized according to the Oxfordshire Community Stroke Project (OCSP) classification. Age, gender, risk factors, previous vascular disease, in-hospital complications, stroke severity, functional status, therapy and living place at admission, discharge and after 6 months were recorded. Follow-up was available for 97% patients at 5 years.
Survival probability was 91% (95% CI = 88-94) at 1 month, 84% (80-88) at 6 months and 64% (58-69) at 5 years. Mortality was higher for the TACI (total anterior circulation infarct) group compared to the other categories (p < 0.0001). Hazard ratios for 5-year mortality in the final model were: 5.4 for age >or=65 years (p < 0.0001), 2.8 for TACI (p < 0.0001), 2.7 for previous vascular disease (p < 0.01) and 1.9 for cardio-embolic risk according to the TOAST risk stratification (p < 0.05).
Our study extends the prognostic value of the OCSP classification to 5-year survival.