Increased long-term mortality in stroke survivors

Even patients who survive the first year after stroke and are able to live at home have increased risk of dying prematurely, according to the PhD thesis of Sara Maria Mathisen.


MAIN RESULTS:

  1. Stroke patients that are still alive after one year have increased mortality compared to stroke-free individuals.
  2. Even patients who are able to move home after stroke have increased risk of premature death.
  3. Patients with carotid artery stenosis live longer if they use cholesterol-lowering drugs.

THESIS DEFENCE:

Thesis: Risk factors influencing long-term survival and nursing home placement in stroke survivors and patients with carotid stenosis
Candidate: Sara Maria Mathisen
Time: January 11, 2018 at 10:30
Place: South Building, Stavanger University Hospital: The Aula on the third floor
Link to university website (in Norwegian)


SUMMARY:

(1) The first paper includes 1137 stroke patients who were still alive one year after they had been admitted to Stavanger University Hospital between 1996 and 2004. At follow-up in 2012 half of the patients were dead. Among age- and sex-matched stroke-free individuals living in the same area, only one third were dead. The increased mortality rate persisted throughout the whole follow-up period.

Age, diabetes, severity of stroke, low levels of cholesterol and hemoglobin, and high levels of homocystein and creatinine were associated with increased mortality among the stroke survivors. On the other hand, previous stroke, atrial fibrillation or coronary artery disease were not associated with mortality.

(2) During follow-up, more than half of all stroke survivors who were discharged to their homes directly from the hospital or following rehabilitation, died. Only one third of the control population died. Also, more of the home-based stroke survivors moved to a nursing home during follow-up compared to the controls.

Almost 90 % of the 452 patients included in the study were able to live at home following stroke.

(3) Patients with known carotid artery stenosis had lower risk of dying prematurely if they were on cholesterol-lowering therapy. The difference in survival compared to those who did not use statins increased with longer duration of follow-up.


REFERENCES:

(1) Mathisen, S. M., Dalen, I., Larsen, J. P., & Kurz, M. (2015). Long-Term Mortality and Its Risk Factors in Stroke SurvivorsJournal of Stroke and Cerebrovascular Diseases.

(2) Mathisen, S. M., Larsen, J. P., & Kurz, M. W. (2017). The prognosis of stroke survivors primarily discharged to their homesActa Neurologica Scandinavica.