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

Cerebrovasc Dis. 2009;27(1):29-36. doi: 10.1159/000172631. Epub 2008 Nov 15.

Abstract

Background: Few studies have addressed predictors of long-term mortality after first-ever ischaemic stroke.

Methods: 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.

Results: 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).

Conclusions: Our study extends the prognostic value of the OCSP classification to 5-year survival.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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