Long-term survival of young stroke patients: a population-based study of two stroke registries from tartu, estonia

The aim of this paper was to evaluate the long-term survival of young stroke patients in Estonia, analyse time trends of survival, and compare the results with other studies. We have used 2 population-based first-ever stroke registry data (1991-1993 and 2001-2003) to analyse the 1-, 5-, and 7-year outcome of young stroke patients by the Kaplan-Meier method of analysis. From the group of 1206 patients, 129 (11%) were aged under 55 years. The overall survival rate at 1, 5, and 7 years was 0.70 (95% CI 0.62-0.78), 0.63 (95% CI 0.55-0.72), and 0.61 (95% CI 0.53-0.70), respectively. The survival was significantly worse for patients with intracerebral haemorrhage (P < 0.01) and for those aged from 45 to 54 years compared to the younger age group from 0 to 44 years (P = 0.03). For patients with ischemic stroke, aged from 15 to 44 years, the 1-, 5-, and 7-year survival rate was 0.89 (95% CI 0.79-1.00), 0.75 (95% CI 0.61-0.93), and 0.75 (0.61-0.93), respectively. There was no difference in overall survival between the two studied periods. We report a low long-term survival rate among young stroke patients in Estonia. Increasing age and hemorrhagic stroke subtype were associated with lower survival. We have previously shown a worse outcome for 1-year survival compared to other studies and currently this trend continues for 5- and 7-year survival rates. In fact, these are the lowest survival rates for the combined and separate stroke subtypes reported so far.