title: Predictors of long-term survival among first-ever ischemic and hemorrhagic stroke in a Brazilian stroke cohort.
abstract: BACKGROUND
  Few studies have examined both ischemic and hemorrhagic stroke to identify prognostic factors associated to long-term stroke survival. We investigated long-term survival and predictors that could adversely influence ischemic and hemorrhagic first-ever stroke prognosis.
  
  
  METHODS
  We prospectively ascertained 665 consecutive first-ever ischemic and hemorrhagic stroke cases from "The Study of Stroke Mortality and Morbidity" (The EMMA Study) in a community hospital in São Paulo, Brazil. We evaluated cardiovascular risk factors and sociodemographic characteristics (age, gender, race and educational level).
  
  
  RESULTS
  We found a lower survival rate among hemorrhagic cases compared to ischemic stroke cases at the end of 4 years of follow-up (52% vs. 44%, p = 0.04). The risk of death was two times higher among people with ischemic stroke without formal education. Also, we found consistently higher risk of death for diabetics with ischemic stroke (HR = 1.45; 95% CI = 1.07-1.97) compared to no diabetics. As expected, age equally influenced on the high risk of poor survival, regardless of stroke subtype.
  
  
  CONCLUSIONS
  For ischemic stroke, the lack of formal education and diabetes were significant independent predictors of poor long-term survival.
authors.forename: Alessandra C
authors.initials: AC
authors.lastname: Goulart
authors.forename: Tiotrefis G
authors.initials: TG
authors.lastname: Fernandes
authors.forename: Itamar S
authors.initials: IS
authors.lastname: Santos
authors.forename: Airlane P
authors.initials: AP
authors.lastname: Alencar
authors.forename: Isabela M
authors.initials: IM
authors.lastname: Bensenor
authors.forename: Paulo A
authors.initials: PA
authors.lastname: Lotufo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000401:mortality*; D001938:Brazil / Q000453:epidemiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate