Outcomes after first-ever stroke

Abstract

OBJECTIVES. To determine the outcomes after first-ever stroke, including mortality, dependence, and recurrence.

DESIGN. Retrospective study on a prospectively collected cohort.

SETTING. Regional hospital, Hong Kong.

PATIENTS. A cohort of 755 patients presented to our hospital from 1996 to 1998 with their first-ever stroke.

MAIN OUTCOME MEASURES. Mortality and stroke recurrence rate at 30 days, 1 year, and 5 years from the onset of the stroke. Dependence in activity of daily living at 5 years from the onset of stroke.

RESULTS. The mortality rate was 15.1% at 30 days, 22.5% at 1 year, and 39.7% at 5 years from the onset of the first-ever stroke. The rate of stroke recurrence was 0.9% at 30 days, 7.0% at 1 year, and 21.2% at 5 years from the onset of first-ever stroke. Among patients presenting with ischaemic strokes, 109 (20.6%) had a recurrence, of which 92 (84%) were ischaemic strokes and 17 (16%) were haemorrhagic. Among patients presenting with intracerebral haemorrhage, 25 (23.1%) had a recurrence, of which 12 (48%) were haemorrhagic strokes and 13 (52%) patients were ischaemic. After 5 years, 11% of the patients were dependent in terms of activity of daily living.

CONCLUSIONS. The long-term prognosis after first-ever stroke is poor—5 years after their stroke, 39.7% of patients had died and 10.7% were dependent in terms of activity of daily living; 136 (21%) who survived at least 30 days after the initial stroke, had a recurrence within 5 years.