Predictors of long-term mortality after first-ever stroke

• Published in: Journal of Education and Health Promotion 2020-01, Vol.9 (1), p.45-45
• Main Authors: Novbakht, Hossein, Shamshirgaran, Seyed, Sarbakhsh, Parvin, Savadi-Oskouei, Darioush, Yazdchi, Mohammad, Ghorbani, Zohreh
• Format: Article
• Language: English
• Subjects: Age; Attrition (Research Studies); Blood pressure; Body Composition; Body mass index; Cardiovascular disease; Consent; Developed Nations; Diabetes; Family medical history; Fatalities; Gender; Glucose; Heart; Heart Disorders; hemorrhagic stroke; Hospitalization; Hypertension; ischemic stroke; Magnetic resonance imaging; Mortality; Original; Patients; Stroke; survival; Survival analysis
• ISSN: 2277-9531; 2319-6440
• DOI: 10.4103/jehp.jehp_8_19

BACKGROUND AND OBJECTIVE: Data on the factors affecting long-term mortality following a stroke in Iran are scarce. The current research aimed at investigating the extent of 2-year mortality following a stroke and the factors affecting it in the northwest of Iran. MATERIALS AND METHODS: This prospective cohort study was conducted in Tabriz, Northwest of Iran. Patients with computed tomography/magnetic resonance imaging confirmed the first-ever stroke were included in this study and followed up to 2 years. Clinical examinations, including the severity of the stroke using the modified National Institutes of Health Stroke Scale (mNIHSS), were conducted by a neurologist. The general characteristics, lifestyle factors, and laboratory tests were also completed. To estimate the survival, Kaplan–Meier analysis was used; and for group comparison, the log-rank method was applied. To identify the factors predicting 2-year mortality, semiparametric Cox regression analysis was used. RESULTS: A total of 1036 first-ever stroke patients were included in the present study. The mortality rates of stroke in 6-month, 1-year, and 2-years follow-up periods were 31.6%, 34.5%, and 38%, respectively. The two-year mortality rate was 33.6% in ischemic and 58.7% in hemorrhagic stroke (P < 0.001). In the multivariate Cox model, variables age, type of stroke, diabetes, and severity of the stroke, according to the mNIHSS index, were identified as factors predicting 2-year mortality following the stroke. CONCLUSION: The 2-year mortality following acute stroke was relatively high compared to that of in developed countries. Implementation of secondary prevention is recommended to better management of modifiable predictors of mortality.