Survival differences after stroke in a multiethnic population: follow-up study with the South London stroke register.
OBJECTIVE
To identify ethnic differences in survival after stroke and examine the factors that influence survival.


METHODS
Population based stroke register with follow-up.


METHODS
South London stroke register.


METHODS
2321 patients with first stroke registered between January 1995 and December 2002.


METHODS
Sociodemographic factors, risk factors for stroke and their management, severity of stroke, and acute service provision factors. Survival analysis with Kaplan-Meier curves, log rank test, and Cox's proportional hazard model with stratification.


RESULTS
In univariable analyses of survival, outcome was better for black people than white people (median 33.7 v 20.0 months). After stratification by socioeconomic status, type of stroke, and Glasgow coma score, and adjustment for other potential confounders, being black was generally associated with better survival, taking into account the interaction between ethnicity and age, and ethnicity and prior Barthel score. Of the risk factors for stroke considered, current smoking (hazard ratio 1.21, 95% confidence interval 1.01 to 1.45, P = 0.044), untreated atrial fibrillation (1.36, 1.08 to 1.72, P = 0.009), untreated diabetes (1.53, 1.05 to 2.22, P = 0.027), and treated diabetes (1.61, 1.27 to 2.03, P < 0.001) were associated with reduced survival.


CONCLUSIONS
In general, black patients in a south London population with first ever stroke are more likely to survive than white patients, the exceptions being in those aged < 65 and those with a prior Barthel score < 15. Some pre-stroke risk factors that have the potential to be modified, including the appropriate treatment of existing health problems, have a strong impact on survival.
Wolfe
Charles D A
CD
Division of Health and Social Care, King's College London, London SE1 3QD. charles.wolfe@kcl.ac.uk
Smeeton
Nigel C
NC
Coshall
Catherine
C
Tilling
Kate
K
Rudd
Anthony G
AG
D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology* / Q000401:mortality*; D016019:Survival Analysis; D044465:White People / Q000706:statistics & numerical data*