Despite advances in stroke prevention and treatment, Australia still has high long term rates of recurrence and mortality after an acute stroke, new figures show.
In one of the few studies to analyse long term outcomes after stroke, population data from 313,162 patients who had first stroke hospitalisation between 2008 and 2017 showed that only 36.4% of patients survived beyond 10 years, and 26.8% had another stroke.
Published in the journal Stroke, the results showed that compared with the general population, an acute stroke was associated with a loss of 5.5 years of life expectancy, or 33% of the predicted life expectancy, and was more pronounced in patients with a haemorrhagic stroke in whom the loss was 7.4 years, or 38.5% of predicted life expectancy.
The overall post-stroke survival probability was 79.4% at 3 months, 73.0% at 1 year, 52.8% at 5 years, and 36.4% at 10 years.
Cumulative incidence of stroke recurrence was 7.8% at 3 months, 11.0% at 1 year, 19.8% at 5 years, and 26.8% at 10 years.
Haemorrhagic stroke was associated with greater mortality (Hazard Ratio [HR], 2.02) and recurrent stroke (HR 1.63) compared with ischaemic stroke.
Other factor associated with increased mortality were female sex (HR 1.10]) and increasing age (≥85 years versus 18–54 years: HR 7.36).
Several risk factors including atherosclerotic coronary and non-coronary vascular disease, cardiac arrhythmia, and diabetes were associated with increased risk of mortality and recurrent stroke.