High five-year mortality rates of ischemic stroke subtypes: A prospective cohort study in Brazil
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Citações na Scopus
7
Tipo de produção
article
Data de publicação
2019
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS LTD
Autores
CABRAL, Norberto Luiz
NAGEL, Vivian
MAGALHAES, Pedro S. C.
VENANCIO, Vanessa G.
SAFANELLI, Juliana
IBIAPINA, Felipe
MAZIN, Suleimy
FRANCA, Paulo
LIBERATO, Rafaela M.
Citação
INTERNATIONAL JOURNAL OF STROKE, v.14, n.5, p.491-499, 2019
Resumo
Background Studies regarding long-term outcomes of ischemic stroke subtypes are scarce in low- and middle-income countries. We aimed to measure the five-year prognosis of ischemic stroke subtypes in Joinville, Brazil. Methods All first-ever ischemic strokes that occurred in Joinville in 2010 were followed-up for five years. Results We included 334 ischemic stroke patients. Over five years, 156 died, 51 had a recurrent stroke, and 128 were free of recurrent stroke. The overall cumulative risk of death was 17% (95% CI, 13% to 22%) at 30 days and 47% (95% CI, 41% to 52%) after five years. Undetermined with incomplete investigation ischemic stroke had a significantly worse survival probability (beta -4.91; 95% CI, -6.31 to -3.50; p < 0.001), followed by cardioembolic ischemic stroke (beta -3.07; 95% CI, -4.32 to -1.83; p < 0.001) and large artery disease ischemic stroke (beta -1.95; 95% CI, -3.30 to -0.60; p = 0.005). The survival probability of undetermined with negative investigation or cryptogenic ischemic stroke did not differ significantly from small artery disease ischemic stroke (beta -1.022; 95% CI, -3.37 to -1.43; p = 0.414). The five-year mortality for small artery disease ischemic stroke was 30% (95% CI, 22% to 39%) and 47% (95% CI, 35% to 60%) for large artery ischemic stroke. The risk of stroke recurrence was 2% in the first year and 5% in the second year. The proportion of disability among survivors in the first month ranged from 8% (95% CI, 3-15) for small artery disease ischemic stroke to 40% (95% CI, 30-52) for cardioembolic ischemic stroke patients. Conclusions Cardioembolic and undetermined with incomplete investigation ischemic stroke sub-types have a poor long-term prognosis. An alarming finding was that our patients with both small and large artery ischemic stroke had higher five-year mortality rates compared with subjects from high-income countries.
Palavras-chave
Ischemic stroke subtype, epidemiology, incidence, recurrence, stroke prognosis, survival
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