Abstract
Background and Purpose: Despite recent declines in stroke mortality in high-income countries, the incidence and mortality of stroke have increased in many low- and middle-income countries. Population-based information on stroke in such countries is a research priority to address this rising trend. This study was designed to evaluate 5-year stroke mortality and its associated factors. Methods: During a 12-month period beginning from November 2006, 624 patients with first-ever stroke (FES) living in Mashhad, Iran, were recruited and followed longitudinally. Kaplan-Meier analyses were used to determine the cumulative risk of death. Prognostic variables associated with death were assessed using a Cox proportional hazard, backward logistic regression model. Results: The 5-year cumulative risk of death was 53.8% for women and 60.5% for men (log rank =.1). The most frequent causes of death were stroke (41.2%), myocardial infarction/vascular diseases (16.4%), and pneumonia (14.2%). In multivariable Cox proportional hazard analysis, male gender (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 1.01-1.64), age (HR: 1.04, 95% CI: 1.03-1.05, per 1-year increase), National Institute of Health Stroke Scale score at admission (HR: 1.11, 95% CI: 1.09-1.12, per 1-point increase), atrial fibrillation (HR: 1.78, CI: 1.24-2.54), and education < 12 years (HR: 1.61, 95% CI: 1.08-2.4) were associated with greater 5-year case fatality. Conclusions: Long-term case fatality following stroke in Iran is greater than that observed in many high-income countries. Targeting strategies to reduce the poor outcome following stroke, such as treating AF, is likely to reduce this disparate outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 1085-1089 |
| Number of pages | 5 |
| Journal | Journal of Stroke and Cerebrovascular Diseases |
| Volume | 27 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - 1 Apr 2018 |
Keywords
- Middle East
- mortality
- population based
- Stroke
Cite this
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Five-Year Case Fatality Following First-Ever Stroke in the Mashhad Stroke Incidence Study : A Population-Based Study of Stroke in the Middle East. / Farzadfard, Mohammad Taghi; Thrift, Amanda G.; Amiri, Amin; Kapral, Moira K.; Hashemi, Peyman; Sposato, Luciano A.; Salehi, Maryam; Shoeibi, Ali; Hoseini, Alireza; Mokhber, Naghmeh; Azarpazhooh, Mahmoud Reza.
In: Journal of Stroke and Cerebrovascular Diseases, Vol. 27, No. 4, 01.04.2018, p. 1085-1089.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Five-Year Case Fatality Following First-Ever Stroke in the Mashhad Stroke Incidence Study
T2 - A Population-Based Study of Stroke in the Middle East
AU - Farzadfard, Mohammad Taghi
AU - Thrift, Amanda G.
AU - Amiri, Amin
AU - Kapral, Moira K.
AU - Hashemi, Peyman
AU - Sposato, Luciano A.
AU - Salehi, Maryam
AU - Shoeibi, Ali
AU - Hoseini, Alireza
AU - Mokhber, Naghmeh
AU - Azarpazhooh, Mahmoud Reza
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background and Purpose: Despite recent declines in stroke mortality in high-income countries, the incidence and mortality of stroke have increased in many low- and middle-income countries. Population-based information on stroke in such countries is a research priority to address this rising trend. This study was designed to evaluate 5-year stroke mortality and its associated factors. Methods: During a 12-month period beginning from November 2006, 624 patients with first-ever stroke (FES) living in Mashhad, Iran, were recruited and followed longitudinally. Kaplan-Meier analyses were used to determine the cumulative risk of death. Prognostic variables associated with death were assessed using a Cox proportional hazard, backward logistic regression model. Results: The 5-year cumulative risk of death was 53.8% for women and 60.5% for men (log rank =.1). The most frequent causes of death were stroke (41.2%), myocardial infarction/vascular diseases (16.4%), and pneumonia (14.2%). In multivariable Cox proportional hazard analysis, male gender (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 1.01-1.64), age (HR: 1.04, 95% CI: 1.03-1.05, per 1-year increase), National Institute of Health Stroke Scale score at admission (HR: 1.11, 95% CI: 1.09-1.12, per 1-point increase), atrial fibrillation (HR: 1.78, CI: 1.24-2.54), and education < 12 years (HR: 1.61, 95% CI: 1.08-2.4) were associated with greater 5-year case fatality. Conclusions: Long-term case fatality following stroke in Iran is greater than that observed in many high-income countries. Targeting strategies to reduce the poor outcome following stroke, such as treating AF, is likely to reduce this disparate outcome.
AB - Background and Purpose: Despite recent declines in stroke mortality in high-income countries, the incidence and mortality of stroke have increased in many low- and middle-income countries. Population-based information on stroke in such countries is a research priority to address this rising trend. This study was designed to evaluate 5-year stroke mortality and its associated factors. Methods: During a 12-month period beginning from November 2006, 624 patients with first-ever stroke (FES) living in Mashhad, Iran, were recruited and followed longitudinally. Kaplan-Meier analyses were used to determine the cumulative risk of death. Prognostic variables associated with death were assessed using a Cox proportional hazard, backward logistic regression model. Results: The 5-year cumulative risk of death was 53.8% for women and 60.5% for men (log rank =.1). The most frequent causes of death were stroke (41.2%), myocardial infarction/vascular diseases (16.4%), and pneumonia (14.2%). In multivariable Cox proportional hazard analysis, male gender (hazard ratio [HR]: 1.29, 95% confidence interval [CI]: 1.01-1.64), age (HR: 1.04, 95% CI: 1.03-1.05, per 1-year increase), National Institute of Health Stroke Scale score at admission (HR: 1.11, 95% CI: 1.09-1.12, per 1-point increase), atrial fibrillation (HR: 1.78, CI: 1.24-2.54), and education < 12 years (HR: 1.61, 95% CI: 1.08-2.4) were associated with greater 5-year case fatality. Conclusions: Long-term case fatality following stroke in Iran is greater than that observed in many high-income countries. Targeting strategies to reduce the poor outcome following stroke, such as treating AF, is likely to reduce this disparate outcome.
KW - Middle East
KW - mortality
KW - population based
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85041706689&partnerID=8YFLogxK
U2 - 10.1016/j.jstrokecerebrovasdis.2017.11.018
DO - 10.1016/j.jstrokecerebrovasdis.2017.11.018
M3 - Article
VL - 27
SP - 1085
EP - 1089
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
SN - 1052-3057
IS - 4
ER -