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[Risk factors for early death and recurrence in stroke]
1Altalános Orvostudományi Kar, II. Belgyógyászati Klinika, Semmelweis Egyetem, Budapest.
Abstract:
The early case fatality rate (28-day mortality) in 500 acute stroke patients of Budapest Stroke Data Bank was 17% and it was 25% within the first year with an increase between 1-3% annually. In the group with early death significantly higher age (p < 0.0001), more serious neurological symptoms, impaired consciousness (p < 0.0001), and higher volume of the lesions (p < 0.0001) have been detected. In this group significantly more stroke in the territory of vertebrobasilar system, a higher number of ischemic heart disease, and atrial fibrillation have been registered. According to the stroke subtypes there were significantly more cardiogenic embolisms, and hemorrhages, but less lacunar infarcts. The level of blood sugar at admission, and the rate of low platelets were higher among patients, who died within 28 days. Significantly higher percentage of the regions in the right frontal, right parietal, right occipital lobes and right thalamus have been affected in the early death group than in the survivors' group, however no such difference have been found in the lesions of the left homological structures. Severity of recurrent strokes have been more serious, and among patients with repetitive stroke significantly more ischemic heart diseases have been demonstrated. Atherosclerosis is the main risk for a new cerebrovascular accident. The case recurrent rate in the first 28 days is 7%, and it is 16% within the first year. The annual increase was between 1-5%. 71% of the recurrent strokes had the same mechanism as the first one.