Predictors of death among long-term stroke survivors

Background and Purpose - We evaluated the risk factors for death among long- term stroke survivors compared with stroke- free subjects. Methods - In 1997 we investigated 221 stroke survivors ( mean, 9.4 years after index stroke) and 243 stroke- free subjects; both groups were recruited from a population- based health study. During the subsequent 5 years, all deaths ( 51 and 21 in the stroke and stroke- free groups, respectively) were registered. Results - The age- and sex- adjusted total mortality rate for the 5- year follow- up was 21.0% in the stroke group and 7.9% in the stroke- free group ( P < 0.0001), depending on different rates of cardiovascular deaths ( P < 0.0001). Better physical and social functioning ( P < 0.0001) and moderate use of alcohol ( P ≤ 0.004), the latter compared with no use, decreased risk of death, irrespective of stroke status. A myocardial infarction risk score had no impact on death in the stroke group, in contrast to the increased risk seen among the stroke- free group ( P = 0.0001). Conclusions - The long- term stroke survivors had significant excess risk of death compared with stroke- free subjects. Better physical and social functioning and moderate use of alcohol were associated with decreased risk, whereas a myocardial infarction risk score increased risk for death only in the stroke- free group.