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Survival at 30 Days and 1 Year
Stroke Survival by Subtype I
A wide variety of variation exists
in the reported survival rates for patients with stroke and
its several subtypes. The two major factors potentially
contributing to this variability include methodological differences
between studies and a decline in fatality rates over time,
due to improved supportive care and/or other, as yet poorly
defined, determinants.
Data on the "natural history" of stroke
in Rochester, Minnesota from 1955 through 1969 point
to an observation that is repeatedly made in subsequent studies,
namely that short-term (30-day) survival rates are substantially
higher for patients who have sustained an ischemic rather
than a hemorrhagic stroke [Matsumoto N, et al. Stroke. 1973;
4:20]
In evaluation of outcome from various types
of strokes was obtained by analysis of data from the Framingham
Study [Kelly-Hayes M, et al. Arch Phys Med Rehab. 1988;69:415].
In the present analysis, a total of 213 patients who had completed
strokes occurring between 1971 and 1981 were evaluated.
Patients in whom stroke was suspected were seen during hospitalization
by a neurologist. From 1971 and to 1978, most of these
patients had lumbar puncture, brain scan, and EEG; from 1978
on, CT scans were regularly performed. Almost three
quarters of the patients (72%) survived more than 30 days.
Acute survival was dependent on stroke type and was negatively
influenced by severity of neurologic impairment, and age.
Only about one-third of hemorrhagic stroke patients survived
the acute phase, but more than three-quarters of those with
ischemic stroke (cerebral thrombosis or cerebral embolism)
were alive at 20 days. Forty percent of patients who
survived at least 30 days, 27% were in institutions at follow-up
one year later. The data on institutionalization were
not analyzed by type of stroke.
In the Oxfordshire Community Stroke Project,
a prospective-based study of 675 consecutive patients with
a first-ever stroke, over 90% of patients had CT and/or necropsy
examinations [Bamford J, et al. J Neurol Nurosurg Psychiatry.
1900;53:16]. Shown are survival rates by type of stroke
at 30 days and 1 year. At 1 year, 35% of those surviving
a cerebral infarction were in some way dependent on others,
based on the modified Rankin scale. In this study, there
was no significant difference in functional dependence at
1 year between patients surviving a cerebral infarction and
those surviving primary intracranial hemorrhage or subarachnoid
hemorrhage.
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Stroke Education
