Improvement of survival in Polish stroke patients is related to reduced stroke severity and better control of risk factors: the Krakow Stroke Database.
BACKGROUND
In the last decade, the stroke mortality rate in Poland significantly decreased. We hypothesised that stroke severity, the major determinant of outcome, is lowered in Polish stroke patients.


METHODS
We compared the stroke severity in two cohorts of first-ever ischaemic stroke patients admitted within 24 h after stroke onset to the Department of Neurology, Jagiellonian University, Krakow in the years 1994-2000 and 2008-2012. To assess stroke severity we used the National Institute of Health Stroke Scale (NIHSS). We defined mild stroke as an NIHSS score ≤ 4.


RESULTS
We included 816 patients hospitalised in the years 1994-2000 and 569 patients hospitalised in the years 2008-2012. NIHSS score on admission was higher in the former (mean: 12.0 ±7.0 vs. 8.0 ±6.0, p < 0.01), and the frequency of mild stroke was higher in the latter (12.7% vs. 41.8%, p < 0.01). Although the frequency of hypertension (67.3% vs. 81.2%, p < 0.01), diabetes mellitus (20.8% vs. 26.4%, p = 0.02) and atrial fibrillation (20.7% vs. 26.2%, p = 0.02) was higher in patients hospitalised in the years 2008-2012, the systolic and diastolic blood pressure values and the frequency of fasting hyperglycaemia were lower in this cohort. This cohort also less frequently suffered from hypercholesterolaemia (25.4% vs. 16.3%, p < 0.01).


CONCLUSIONS
Reduced stroke severity is associated with better recognition and control of risk factors and explains the improvement of survival in Polish stroke patients.
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Marta
M
Swarowska
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Jacek
J
Burkot
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Aleksandra
A
Janowska
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Aleksandra
A
Klimkowicz-Mrowiec
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Joanna
J
Pera
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Agnieszka
A
Slowik
Department of Neurology, Jagiellonian University Medical College, Krakow, Poland.
Tomasz
T
Dziedzic
hypercholesterolaemia; hypertension; ischaemic stroke; risk factors; stroke severity