Long-Term Mortality in Cerebrovascular Disease
| Autor: | Jeanne D. Scinto, John Concato, Lawrence M. Brass, Shih-Yieh Ho, Dawn M. Bravata, Thomas P. Meehan |
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| Rok vydání: | 2003 |
| Předmět: |
Male
medicine.medical_specialty Population Comorbidity Medicare Cohort Studies Age Distribution Risk Factors Acute care Epidemiology medicine Humans Intensive care medicine education Stroke Aged Demography Cause of death Aged 80 and over Advanced and Specialized Nursing education.field_of_study business.industry medicine.disease Survival Rate Cerebrovascular Disorders Connecticut Stenosis Acute Disease Cohort Emergency medicine Female Neurology (clinical) Cardiology and Cardiovascular Medicine business Follow-Up Studies Cohort study |
| Zdroj: | Stroke. 34:699-704 |
| ISSN: | 1524-4628 0039-2499 |
| DOI: | 10.1161/01.str.0000057578.26828.78 |
| Popis: | Background and Purpose— Stroke is the third leading cause of death in the United States, yet data are limited about the temporal pattern of mortality among patients with cerebrovascular disease. The objectives of this study were to identify predictors of 6-month mortality and to evaluate 5-year mortality in patients with cerebrovascular disease. Methods— Our population included fee-for-service Medicare beneficiaries aged ≥65 years who were discharged with an acute ischemic stroke, transient ischemic attack (TIA), or carotid stenosis ( International Classification of Diseases, Ninth Revision, Clinical Modification codes 433 to 436) from Connecticut acute care hospitals in 1995. This cohort was followed through 2000 by means of part A Medicare claims and Social Security Administration mortality data. Results— Among 5123 patients, 4781 survived their hospitalization and were followed for an average of 3.4 years; 670 (14.0%) died within 6 months of discharge, and 2517 (52.6%) died within 5 years. Predictors of 6-month mortality included older age, male sex, increasing comorbidity, discharge not to home, and prior admission within a year of the index hospitalization. The annual mortality rates for year 1 after discharge differed depending on the discharge diagnosis of the index hospitalization: carotid stenosis, 10.6%; TIA, 14.8%; and acute ischemic stroke, 26.4%. The 5-year cumulative mortality rates were as follows: carotid stenosis, 38.3%; TIA, 49.6%; and acute ischemic stroke, 60.0%. Conclusions— Mortality after acute ischemic stroke, TIA, and carotid stenosis is substantial. Rates and patterns of mortality differ according to patients’ discharge diagnoses. |
| Databáze: | OpenAIRE |
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