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Life expectancies among survivors of acute cerebrovascular disease
1National Institute of Occupational Health, Copenhagen, Denmark. hh@ami.dk
Insights
Life expectancy for stroke survivors has improved, but remains lower than the general population. This study provides crucial age- and sex-specific life expectancy data for cerebrovascular disease survivors.
Area of Science:
- Public Health
- Epidemiology
- Gerontology
Background:
- Stroke survivors lack age-differentiated life expectancy tables.
- Such tables are essential for various planning and research purposes.
Purpose of the Study:
- To estimate age- and sex-specific life expectancies for cerebrovascular disease (CVD) survivors.
- To provide updated life expectancy data for this population.
Main Methods:
- Utilized the Swedish National Hospital Discharge Registry for CVD patients (ICD codes 430-438) admitted between 1989-1993.
- Followed 103,591 survivors for mortality rates in 1994 and 1983.
- Applied actuarial analyses to convert death rates into life expectancies.
Main Results:
- Life expectancy for CVD survivors increased significantly between 1983 and 1994 (22.9% for men, 12.9% for women).
- In 1994, life expectancy ratios for male and female survivors compared to the general population were 0.641 and 0.611, respectively.
- Prognosis varied by stroke type, with better outcomes for precerebral artery conditions compared to intracerebral hemorrhage.
Conclusions:
- Prognosis for stroke survivors has improved across all age groups.
- Despite improvements, stroke survivors continue to have a lower life expectancy than the general population.
Background And Purpose:
Stroke survivors represent a large group of persons for whom age-differentiated life expectancy tables do not exist. Such tables are vital for many purposes. The aim of the present study was to estimate age- and sex-specific life expectancies among individuals who have survived the acute phase (1 month) of a cerebrovascular disease (CVD).
Methods:
All patients who were registered with the Swedish National Hospital Discharge Registry with an admission for CVD (ICD codes 430 to 438) between January 1, 1989, and November 30, 1993, and were alive at the end of 1993 (N=103 591) were followed for mortality rates in 1994. The same was done for 1983. Actuarial analyses were used to convert death rates into life expectancies.
Results:
Life expectancy among CVD survivors increased with time (1983 versus 1994): 22.9% for men (95% CI 18.3% to 27.6%) and 12.9% for women (95% CI 9.1% to 16.6%). The life expectancy ratio in 1983 between CVD survivors and the general population was 0.571 (95% CI 0.533 to 0.590) for men and 0.578 (95% CI 0.562 to 0.592) for women. In 1994, the corresponding ratios were 0.641 (95% CI 0.629 to 0.654) and 0.611 (95% CI 0.601 to 0.622). The life expectancy ratios between female and male survivors were 1.28 (95% CI 1.23 to 1.34) in 1983 and 1.18 (95% CI 1.15 to 1.21) in 1994. The prognosis for survivors who experienced occlusion and stenosis of the precerebral arteries was better than that for survivors of an intracerebral hemorrhage (P=4.4E-4) or occlusion of cerebral arteries (P=3.8E-8).
Conclusions:
Although the prognosis has improved for all ages, stroke survivors still constitute a large group of persons with a low life expectancy compared with the general population.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Ischemic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology