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[Risk factors for early death and recurrence in stroke]
1Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest.
Orvosi Hetilap
|May 9, 2001
Summary
Acute stroke patients face significant early mortality (17%) and long-term risks. Factors like age, neurological severity, and specific stroke types influence survival, highlighting the need for targeted interventions.
Area of Science:
- Neurology
- Cardiology
- Public Health
Context:
- The Budapest Stroke Data Bank study analyzed 500 acute stroke patients to determine early and long-term mortality rates.
- Investigated factors associated with early death, including patient demographics, stroke characteristics, and comorbidities.
- Examined the incidence and characteristics of recurrent strokes.
Purpose:
- To identify predictors of 28-day and one-year mortality in acute stroke patients.
- To analyze the relationship between stroke subtype, lesion location, and patient outcomes.
- To assess the recurrence rate of stroke and associated risk factors.
Summary:
- Early case fatality rate (28-day mortality) was 17%, rising to 25% within the first year, with annual increases of 1-3%.
- Factors significantly associated with early death included advanced age, severe neurological symptoms, impaired consciousness, larger lesion volume, vertebrobasilar system strokes, ischemic heart disease, and atrial fibrillation.
- Stroke subtypes linked to higher early mortality were cardiogenic embolisms and hemorrhages, while lacunar infarcts were less common. Higher admission blood sugar and lower platelet counts were observed in non-survivors.
- Right-sided brain lesions (frontal, parietal, occipital lobes, and thalamus) were more prevalent in the early death group.
- Recurrent stroke severity was higher, with ischemic heart disease being a significant comorbidity. Atherosclerosis is identified as a primary risk for recurrent cerebrovascular accidents.
- The 28-day recurrent stroke rate was 7%, increasing to 16% within the first year, with an annual rise of 1-5%. 71% of recurrent strokes shared the same mechanism as the initial event.
Impact:
- Identifies critical risk factors for acute stroke mortality and recurrence, informing clinical decision-making and patient management strategies.
- Highlights the importance of managing comorbidities like ischemic heart disease and atrial fibrillation in stroke patients.
- Provides data for public health initiatives aimed at reducing stroke burden and improving patient outcomes.