Predictors for 5-year survival in a prospective cohort of elderly stroke patients.
OBJECTIVE
To examine predictors for 5-year survival in elderly stroke patients.


METHODS
Prospective cohort study of 186 consecutive acute stroke patients aged ≥65 years admitted to Bankstown-Lidcombe Hospital, Australia 03/2002 to 03/2003. All subjects were followed up in 2007/8, at 5 years post-stroke, for outcome measures. Logistic regression analysis was performed to predict 5-year survival using covariables, including functional status, age, stroke type and severity and vascular risk factors. Patients lost to follow-up (n = 20) were excluded from the analyses.


RESULTS
One hundred patients (60%) were dead at study end. Predictors for survival in final logistic regression model were as follows: Glasgow Coma Scale (GCS) on admission (OR 1.49, 95%CI 1.1-2.0, P = 0.01), preadmission functional independence measure (FIM) score (OR 1.04, 95%CI 1.0-1.1, P = 0.01), age (OR 0.93, 95%CI 0.87-0.98, P = 0.01) and atrial fibrillation (OR 0.43, 95% CI 0.19-0.95, P = 0.04). For 5-year survivors, mean Modified Rankin Scale was 3.1 ± 1.5, total FIM score 85 ± 32, mini-mental state examination (MMSE) 22 ± 8 and Hospital Anxiety and Depression (HAD) scores 5.4 ± 3.4 and 5.2 ± 3.9, respectively. FIM cognition score was significantly lower at 5 years when compared to baseline (24 ± 8 vs 29 ± 8, P < 0.05) (all scores expressed as mean ± SD). In contrast, MMSE, HAD and total FIM scores were not significantly different at 5 years when compared to baseline.


CONCLUSIONS
The study identified lower GCS on admission, lower preadmission FIM score, age and atrial fibrillation as negative predictors for 5-year survival following stroke.
Department of Clinical Geratology, John Radcliffe Hospital, Oxford, UK.
R
R
Whiting
Q
Q
Shen
W T
WT
Hung
D
D
Cordato
D K Y
DK
Chan
D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000401:mortality / Q000523:psychology; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D009517:New South Wales / Q000453:epidemiology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D020521:Stroke / Q000175:diagnosis / Q000401:mortality* / Q000523:psychology; D015996:Survival Rate / Q000639:trends