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Long-term mortality in cerebrovascular disease
Dawn M Bravata1, Shih-Yieh Ho, Lawrence M Brass
1Medical Service, Veterans Affairs Connecticut Healthcare System, West Haven, Conn, USA. Dawn.Bravata@yale.edu
Stroke
|March 8, 2003
Summary
Mortality after stroke, TIA, or carotid stenosis is significant, with over half of patients dying within five years. Predictors of early death include older age, male sex, and comorbidities.
Area of Science:
- Neurology
- Public Health
- Geriatrics
Background:
- Stroke is a leading cause of death in the US.
- Limited data exists on mortality patterns in cerebrovascular disease patients.
Purpose of the Study:
- Identify predictors of 6-month mortality.
- Evaluate 5-year mortality in patients with cerebrovascular disease.
Main Methods:
- Cohort study of Medicare beneficiaries aged 65+ discharged with acute ischemic stroke, TIA, or carotid stenosis in 1995.
- Follow-up through 2000 using Medicare claims and mortality data.
Main Results:
- 14.0% died within 6 months; 52.6% died within 5 years.
- Predictors of 6-month mortality: older age, male sex, comorbidity, non-home discharge, prior admission.
- Year 1 mortality: Carotid Stenosis 10.6%, TIA 14.8%, Ischemic Stroke 26.4%.
Conclusions:
- Substantial mortality exists after acute ischemic stroke, TIA, and carotid stenosis.
- Mortality rates and patterns vary by discharge diagnosis.