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Long term survival: predictors and trends in the South London Stroke Register from 1995 to 2009

Research output: Contribution to journalConference paper

Original languageEnglish
Pages (from-to)208-208
Number of pages1
JournalCEREBROVASCULAR DISEASES
Volume31
Issue numbersuppl. 2
Publication statusPublished - May 2011
Event20th European Stroke Conference, Hamburg, May 2011. - Hamburg, Germany
Duration: 24 May 201127 May 2011

King's Authors

Abstract

Aim: To estimate survival up to 15 years after a first-ever stroke and the influence of year of stroke, sociodemographic, case-mix, stroke subtype and acute stroke care factors on survival.
Methods: Population based stroke register registering first in a lifetime strokes between 1995 and 2009. Baseline data collected on sociodemographic factors, subtype, case mix, risk factors prior to stroke, and acute stroke care variables. Survival curves were estimated with Kaplan-Meier Methods and multivariate survival analyses were undertaken using Cox Proportional-hazards models.
Results: Among 4037 patients with a first-ever stroke between 1st January 1995 and 31st December 2009, 2514 (62.3%) have died (all causes) by 31st May 2010. Survival gradually improved over this 15-year period as shown in Kaplan-Meier curves for patients registering in each consecutive 3-year period (P-value<0.0001). The significant factors influencing all-cause mortality were age, year of stroke, ethnic group, case-mix, subtype, stroke unit admission, and risk factors prior to stroke such as MI (myocardial infarction), AF (atrial fibrillation), diabetes and smoking. Recent stroke (calendar year of stroke), being black Caribbean or black African, non-manual employment and stroke unit admission were shown generally associated with better survival after adjusting for age, gender, case mix, stroke subtype and other potential confounders. Patients with PICH (Hazard ratio: 1.15[1.01, 1.32]) and SAH (Hazard ratio: 1.40[1.09, 1.79]) had worse survival than those with Cerebral infarct. Of the risk factors prior to stroke, MI, AF, diabetes and current smoker were associated with reduced survival.
Conclusions: Survival has gradually improved for patients from South London Stroke Register between 1995 and 2009. Recent stroke (calendar year of stroke), infarct subtype, being black Caribbean or black African, non-manual employment and stroke unit admission were associated with better survival.

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