Long-Term Survival After an Ischemic Stroke. The Esh Stroke Survey

Objective: Identification of factors affecting long-term survival following ischemic stroke is of utmost importance. The aim of the present study was to assess long-term survival and factors associated with increased mortality after an ischemic stroke. Design and method: Consecutive patients hospitalized between March 2009 and January 2012 for their first-ever ischemic stroke in 2 large university hospitals in the Czech Republic were enrolled in this survey. Baseline data were obtained from hospital medical records. The median follow-up was 10.2 years. Vital status was determined using the death registry on July 28, 2023. Results: In total, 736 patients (mean age 66 ±11 years; 58% men) were included in this analysis. The cumulative risk of death at 1, 3, 5 and 10 years was 13.6%, 20.8%, 29.3% and 48.4%, respectively. After adjusting for age and sex, patients with discharge systolic blood pressure between 110 and 150 mmHg had the lowest mortality risk (Figure 1). Increased age, higher NIHSS and increased functional impairment, diabetes, and current smoking were associated with higher mortality risk, while lacunar stroke subtype, reperfusion therapy, and renin-angiotensin system blockers were associated with a lower mortality (Figure 2). Conclusions: Despite several advances in stroke management, the mortality remains high. Timely reperfusion therapy applied together with renin-angiotensin system blockers may reduce the risk of mortality.