Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke

TY - JOUR

T1 - Predictors of early and late case-fatality in a nationwide Danish study of 26,818 patients with first-ever ischemic stroke

AU - Andersen, Klaus Kaae

AU - Andersen, Zorana Jovanovic

AU - Olsen, Tom Skyhøj

PY - 2011/10

Y1 - 2011/10

N2 - Background and Purpose-Predictors of early case-fatality (3-day, 7-day, and 30-day) in first-ever ischemic stroke were identified and compared with predictors of late case-fatality (90-day and 1-year). Methods-A registry designed to register hospitalized patients with stroke in Denmark 2000 to 2007 holds 26 818 patients with first-ever ischemic stroke with information on stroke severity (Scandinavian Stroke Scale), CT scan, cardiovascular risk factors, marital status, and fatality within 1 year. Multiple logistic regression was used in identifying predictors. RESULTS-: Mean age was 71.2 years; 48.5% were women; mean Scandinavian Stroke Scale score was 43.9. Early case-fatality showed stroke severity and age were significant predictors of 3-day, 7-day, and 30-day case-fatality (nonlinear effect). In addition, atrial fibrillation (OR, 1.56) predicted 30-day case-fatality. For late case-fatality, significant predictors of 90-day and 1-year case-fatality were age, stroke severity (nonlinear effect), atrial fibrillation (OR, 1.37 and 1.57), and diabetes (OR, 1.35 and 1.33), respectively. Male gender (OR, 1.28), previous myocardial infarction (OR, 1.40), and smoking (OR, 1.21) were also associated with 1-year case-fatality. Alcohol consumption, hypertension, intermittent arterial claudication, and marital state had no influence. All case-fatality rates accelerated with increasing age, but 3-day and 7-day case-fatality rates tended to level off or decline at the highest ages. Conclusions-Age and stroke severity were the only significant predictors of fatality within the first poststroke week; they were associated with late case-fatality as well. Cardiovascular risk factors were associated with late case-fatality; with the exception of atrial fibrillation, they were not significantly associated with early case-fatality rates.

AB - Background and Purpose-Predictors of early case-fatality (3-day, 7-day, and 30-day) in first-ever ischemic stroke were identified and compared with predictors of late case-fatality (90-day and 1-year). Methods-A registry designed to register hospitalized patients with stroke in Denmark 2000 to 2007 holds 26 818 patients with first-ever ischemic stroke with information on stroke severity (Scandinavian Stroke Scale), CT scan, cardiovascular risk factors, marital status, and fatality within 1 year. Multiple logistic regression was used in identifying predictors. RESULTS-: Mean age was 71.2 years; 48.5% were women; mean Scandinavian Stroke Scale score was 43.9. Early case-fatality showed stroke severity and age were significant predictors of 3-day, 7-day, and 30-day case-fatality (nonlinear effect). In addition, atrial fibrillation (OR, 1.56) predicted 30-day case-fatality. For late case-fatality, significant predictors of 90-day and 1-year case-fatality were age, stroke severity (nonlinear effect), atrial fibrillation (OR, 1.37 and 1.57), and diabetes (OR, 1.35 and 1.33), respectively. Male gender (OR, 1.28), previous myocardial infarction (OR, 1.40), and smoking (OR, 1.21) were also associated with 1-year case-fatality. Alcohol consumption, hypertension, intermittent arterial claudication, and marital state had no influence. All case-fatality rates accelerated with increasing age, but 3-day and 7-day case-fatality rates tended to level off or decline at the highest ages. Conclusions-Age and stroke severity were the only significant predictors of fatality within the first poststroke week; they were associated with late case-fatality as well. Cardiovascular risk factors were associated with late case-fatality; with the exception of atrial fibrillation, they were not significantly associated with early case-fatality rates.

KW - Age Factors

KW - Aged

KW - Aged, 80 and over

KW - Atrial Fibrillation

KW - Brain Ischemia

KW - Denmark

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Risk Factors

KW - Severity of Illness Index

KW - Sex Factors

KW - Smoking

KW - Stroke

U2 - 10.1161/strokeaha.111.619049

DO - 10.1161/strokeaha.111.619049

M3 - Journal article

C2 - 21817152

SN - 0039-2499

VL - 42

SP - 2806

EP - 2812

JO - Stroke

JF - Stroke

IS - 10

ER -