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[The study of patient survival in cerebral hemorrhagic and ischemic accident]
V Díaz Tapia1, M A Cumsille Garib, C Arce Rojas
1Servicio de Neurología y Neurocirugía, Hospital Clínico de la Universidad de Chile José Joaquín Aguirre.
Insights
Stroke survival in Chile is poor, with only 19.8% surviving five years. Key factors influencing stroke survival include age, stroke location, heart disease, and rehabilitation.
Area of Science:
- Neurology
- Epidemiology
- Biostatistics
Context:
- Stroke is a leading cause of death and disability worldwide.
- Understanding stroke survival rates is crucial for public health initiatives.
- Chilean stroke survival data provides valuable regional insights.
Purpose:
- To analyze stroke survival in a Chilean historical cohort.
- To identify factors influencing long-term stroke survival.
Summary:
- A cohort of 333 Chilean stroke inpatients was studied.
- Survival probabilities at 1, 3, and 5 years were 48.1%, 39.0%, and 19.8%, respectively.
- Age, stroke localization, infectious disease, heart disease, and rehabilitation significantly impacted survival.
Impact:
- Identifies critical factors for improving stroke patient outcomes.
- Informs clinical practice and public health strategies in stroke care.
- Highlights the need for targeted interventions for high-risk stroke patients.
Abstract:
The aim of this study was to study stroke survival in Chile in a historic cohort from a random sample of 333 inpatients. All alive selected patients were visited and examined. All the death certificates were reviewed. The diagnosis was done by a neurologist, 35% had a CT scan. Survival was measured in days using lifetest procedure to generate survival curves, Cox's proportional hazards models in Stata 3.1 statistic package and logistic regression analysis. The mean age was 70.5 for the group of died and 62.3 years old for alive patients (p = 0.01). Infectious disease (p = 0.05), localization of stroke (p = 0.01) and rehabilitation (p = 0.005) were significant at univariate analysis. The cumulative probability of survival was 38 days, after one year and after five years, 48.1, 39.0 and 19.8%, respectively. The probability of survival by age, localization, heart disease and rehabilitation was statistically significant. Analysis of survival by sex, and previous stroke risk factors was not significant. Using Cox's proportional hazards regression we found that survival after 5 years depends on age (p = 0.03), rehabilitation (p = 0.008), infection (p = 0.05) and heart disease (p = 0.04). Stroke survival function is close to a decreasing exponential curve with high death probability at one month after the stroke. Survival is conditioned by stroke localization, age, heart disease and rehabilitation.