Five-year survival after first-ever ischaemic stroke is worse in total anterior circulation infarcts: the SINPAC cohort.
BACKGROUND
Few studies have addressed predictors of long-term mortality after first-ever ischaemic stroke.


METHODS
We prospectively collected data on 361 consecutive patients admitted to 18 neurology departments in Italy for a first-ever ischaemic stroke in 1999, categorized according to the Oxfordshire Community Stroke Project (OCSP) classification. Age, gender, risk factors, previous vascular disease, in-hospital complications, stroke severity, functional status, therapy and living place at admission, discharge and after 6 months were recorded. Follow-up was available for 97% patients at 5 years.


RESULTS
Survival probability was 91% (95% CI = 88-94) at 1 month, 84% (80-88) at 6 months and 64% (58-69) at 5 years. Mortality was higher for the TACI (total anterior circulation infarct) group compared to the other categories (p < 0.0001). Hazard ratios for 5-year mortality in the final model were: 5.4 for age >or=65 years (p < 0.0001), 2.8 for TACI (p < 0.0001), 2.7 for previous vascular disease (p < 0.01) and 1.9 for cardio-embolic risk according to the TOAST risk stratification (p < 0.05).


CONCLUSIONS
Our study extends the prognostic value of the OCSP classification to 5-year survival.
Reggiani
M
M
Clinica Neurologica, Università del Piemonte Orientale A. Avogadro, Novara, Italia.
D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D006801:Humans; D020243:Infarction, Anterior Cerebral Artery / Q000401:mortality*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality*; D016019:Survival Analysis