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Lacunar infarction, mortality over time and mortality relative to other ischemic strokes

Robert W Lund

    Journal of Insurance Medicine (New York, N.Y.)
    |July 10, 2014
    PubMed

    Insights

    Lacunar infarction is linked to moderately increased mortality compared to the general population. However, risks from atherothrombotic and cardioembolic strokes are significantly higher, especially in the initial years post-stroke.

    Area of Science:

    • Neurology
    • Epidemiology
    • Public Health

    Background:

    • Lacunar infarction is a common type of ischemic stroke.
    • Understanding long-term mortality is crucial for patient management and public health.
    • Comparative mortality data across different ischemic stroke subtypes is limited.

    Purpose of the Study:

    • To determine the overall mortality rate following lacunar infarction.
    • To compare lacunar infarction mortality with that of atherothrombotic and cardioembolic strokes.
    • To analyze the pattern of increased mortality over time after lacunar infarction.

    Main Methods:

    • Systematic literature search for studies with at least 5 years of follow-up mortality data on lacunar infarction.
    • Inclusion of studies providing comparative mortality data for atherothrombotic and cardioembolic strokes.
    • Calculation of average overall mortality ratios (MR) and excess deaths per thousand per year (EDR) using standard mortality methodology and population life tables.

    Main Results:

    • Average overall mortality ratio (MR) for lacunar infarction was 159%, compared to 213% for atherothrombotic stroke and 322% for cardioembolic stroke.
    • Mortality ratios for lacunar infarction decreased over time: 166% (1-5 years), 153% (6-10 years), and 106% (11-14 years).

    Conclusions:

    • Lacunar infarction is associated with a moderately increased overall mortality risk relative to the general population.
    • Atherothrombotic and cardioembolic strokes carry significantly higher post-stroke mortality risks.
    • Mortality risk following lacunar infarction diminishes over time but remains elevated for over a decade.
    Abstract

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