Long-term neurological, vascular, and mortality outcomes after stroke

Area of Science:

• Neurology
• Public Health
• Gerontology

Background:

• Limited data exist on long-term outcomes (≥5 years) for ischemic stroke survivors.
• Focus is on sustained benefits of acute stroke care interventions and long-term prognosis.

Purpose of the Study:

• To review contemporary literature on long-term outcomes after stroke and acute stroke treatment.
• To assess sustained benefits of interventions like intravenous thrombolysis and endovascular thrombectomy (EVT).

Main Methods:

• Systematic literature review of studies reporting on long-term outcomes (≥5 years) post-stroke.
• Analysis of data on residual disability, neuropsychiatric sequelae, stroke recurrence, and mortality.

Main Results:

• Acute stroke unit care and intravenous thrombolysis show sustained benefits.
• Few data exist on long-term outcomes after endovascular thrombectomy (EVT).
• High rates of residual disability, neuropsychiatric issues, stroke recurrence (25% at 5 years, ~50% at 10 years), and mortality (50% deceased at 5 years, 75% at 10 years) are observed.

Conclusions:

• There is a critical need for studies on the long-term effects of acute interventions, particularly EVT.
• Enhanced secondary prevention strategies are essential to mitigate vascular and non-vascular mortality long after stroke.
• Addressing modifiable risk factors can improve long-term prognosis for stroke survivors.