Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry
Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010–2012) and followed-up for 12 months. We...
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| Veröffentlicht in: | Journal of neurology 2018-10, Vol.265 (10), p.2379-2387 |
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| creator | Tsivgoulis, Georgios Katsanos, Aristeidis H. Patousi, Athanasia Pikilidou, Maria Birbilis, Theodosis Mantatzis, Michael Yavropoulou, Maria Zompola, Christina Triantafyllou, Sokratis Papanas, Nikolaos Skendros, Panagiotis Terzoudi, Aikaterini Georgiadis, George S. Zebekakis, Pantelis Maltezos, Efstratios Piperidou, Charitomeni Heliopoulos, Ioannis Vadikolias, Konstantinos |
| description | Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010–2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectively documented 703 first ever stroke cases (mean age 75 ± 12 years; 52.8% males; ischemic stroke 80.8%, intracerebral hemorrhage 11.8%, subarachnoid hemorrhage 4.4%, undefined 3.0%) with a total follow-up time of 119,805 person-years. The cumulative incidence rates of mortality of all FES patients at 28 days, 3 months and 1 year were 21.3% (95% CI 18.5–24.5%), 26% (95% CI 22.9–29.4%) and 34.7% (95% CI 31.3–38.3%), respectively. The risk of 1-year mortality was independently (
p
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| doi_str_mv | 10.1007/s00415-018-9005-6 |
| format | Article |
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p
< 0.05) associated with advancing age, history of hypertension, increased stroke severity on admission, and hemorrhagic FES type. Cumulative 1-year stroke mortality differed according to both index FES type (ischemic vs. hemorrhage;
p
< 0.001), but also across different ischemic stroke subtypes (
p
= 0.025). The cumulative incidence rates of recurrent stroke at 28 days, 3 months and 1 year were 2.0% (95% CI 1.2–3.6%), 4.2% (2.8–6.2%) and 6.7% (5.1–8.8%), respectively. Comparable to other population-based surveys, our study reports 1-year mortality and stroke recurrence rates in patients with FES. These findings highlight the need for effective secondary prevention strategies in a border region of southeastern Europe, which exhibits very high FES incidence rates.</description><identifier>ISSN: 0340-5354</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-018-9005-6</identifier><identifier>PMID: 30128708</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Health risk assessment ; Hemorrhage ; Ischemia ; Medicine ; Medicine & Public Health ; Mortality ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Population studies ; Stroke ; Subarachnoid hemorrhage</subject><ispartof>Journal of neurology, 2018-10, Vol.265 (10), p.2379-2387</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2018</rights><rights>Journal of Neurology is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-515a3109b93ca72890d55f072d0891fd4b21e463e44c72e3e015b08004ffba6f3</citedby><cites>FETCH-LOGICAL-c372t-515a3109b93ca72890d55f072d0891fd4b21e463e44c72e3e015b08004ffba6f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-018-9005-6$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-018-9005-6$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30128708$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tsivgoulis, Georgios</creatorcontrib><creatorcontrib>Katsanos, Aristeidis H.</creatorcontrib><creatorcontrib>Patousi, Athanasia</creatorcontrib><creatorcontrib>Pikilidou, Maria</creatorcontrib><creatorcontrib>Birbilis, Theodosis</creatorcontrib><creatorcontrib>Mantatzis, Michael</creatorcontrib><creatorcontrib>Yavropoulou, Maria</creatorcontrib><creatorcontrib>Zompola, Christina</creatorcontrib><creatorcontrib>Triantafyllou, Sokratis</creatorcontrib><creatorcontrib>Papanas, Nikolaos</creatorcontrib><creatorcontrib>Skendros, Panagiotis</creatorcontrib><creatorcontrib>Terzoudi, Aikaterini</creatorcontrib><creatorcontrib>Georgiadis, George S.</creatorcontrib><creatorcontrib>Zebekakis, Pantelis</creatorcontrib><creatorcontrib>Maltezos, Efstratios</creatorcontrib><creatorcontrib>Piperidou, Charitomeni</creatorcontrib><creatorcontrib>Heliopoulos, Ioannis</creatorcontrib><creatorcontrib>Vadikolias, Konstantinos</creatorcontrib><title>Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010–2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectively documented 703 first ever stroke cases (mean age 75 ± 12 years; 52.8% males; ischemic stroke 80.8%, intracerebral hemorrhage 11.8%, subarachnoid hemorrhage 4.4%, undefined 3.0%) with a total follow-up time of 119,805 person-years. The cumulative incidence rates of mortality of all FES patients at 28 days, 3 months and 1 year were 21.3% (95% CI 18.5–24.5%), 26% (95% CI 22.9–29.4%) and 34.7% (95% CI 31.3–38.3%), respectively. The risk of 1-year mortality was independently (
p
< 0.05) associated with advancing age, history of hypertension, increased stroke severity on admission, and hemorrhagic FES type. Cumulative 1-year stroke mortality differed according to both index FES type (ischemic vs. hemorrhage;
p
< 0.001), but also across different ischemic stroke subtypes (
p
= 0.025). The cumulative incidence rates of recurrent stroke at 28 days, 3 months and 1 year were 2.0% (95% CI 1.2–3.6%), 4.2% (2.8–6.2%) and 6.7% (5.1–8.8%), respectively. Comparable to other population-based surveys, our study reports 1-year mortality and stroke recurrence rates in patients with FES. These findings highlight the need for effective secondary prevention strategies in a border region of southeastern Europe, which exhibits very high FES incidence rates.</description><subject>Health risk assessment</subject><subject>Hemorrhage</subject><subject>Ischemia</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Mortality</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Population studies</subject><subject>Stroke</subject><subject>Subarachnoid hemorrhage</subject><issn>0340-5354</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>BENPR</sourceid><recordid>eNp1kE1Lw0AQhhdRbK3-AC-y4MVLdGY_msSblFqFgvh1XjbJpKa2Sd1NhP57t7QqCJ6W3Xn2mZmXsVOESwSIrzyAQh0BJlEKoKPhHuujkiJCpdN91gepINJSqx478n4OAEkoHLKeBBRJDEmfPT63rnkn7ijvnKM6J27rgi8b19pF1a55VfM6XN7I-pZczSeOKKdrHl74-NM1nu8MTzSrfOvWx-ygtAtPJ7tzwF5vxy-ju2j6MLkf3UyjXMaijTRqKxHSLJW5jUWSQqF1CbEoIEmxLFQmkNRQklJ5LEgSoM4gCRuXZWaHpRywi6135ZqPjnxrlpXPabGwNTWdNwJSFAoTPQzo-R903nSuDtNtKEDEONaBwi2Vh628o9KsXLW0bm0QzCZvs83bhLzNJm-zMZ_tzF22pOLnx3fAARBbwIdSPSP32_p_6xfH0Ylm</recordid><startdate>20181001</startdate><enddate>20181001</enddate><creator>Tsivgoulis, Georgios</creator><creator>Katsanos, Aristeidis H.</creator><creator>Patousi, Athanasia</creator><creator>Pikilidou, Maria</creator><creator>Birbilis, Theodosis</creator><creator>Mantatzis, Michael</creator><creator>Yavropoulou, Maria</creator><creator>Zompola, Christina</creator><creator>Triantafyllou, Sokratis</creator><creator>Papanas, Nikolaos</creator><creator>Skendros, Panagiotis</creator><creator>Terzoudi, Aikaterini</creator><creator>Georgiadis, George S.</creator><creator>Zebekakis, Pantelis</creator><creator>Maltezos, Efstratios</creator><creator>Piperidou, Charitomeni</creator><creator>Heliopoulos, Ioannis</creator><creator>Vadikolias, Konstantinos</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20181001</creationdate><title>Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry</title><author>Tsivgoulis, Georgios ; 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Adult patients with FES were registered during a 24-month period (2010–2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectively documented 703 first ever stroke cases (mean age 75 ± 12 years; 52.8% males; ischemic stroke 80.8%, intracerebral hemorrhage 11.8%, subarachnoid hemorrhage 4.4%, undefined 3.0%) with a total follow-up time of 119,805 person-years. The cumulative incidence rates of mortality of all FES patients at 28 days, 3 months and 1 year were 21.3% (95% CI 18.5–24.5%), 26% (95% CI 22.9–29.4%) and 34.7% (95% CI 31.3–38.3%), respectively. The risk of 1-year mortality was independently (
p
< 0.05) associated with advancing age, history of hypertension, increased stroke severity on admission, and hemorrhagic FES type. Cumulative 1-year stroke mortality differed according to both index FES type (ischemic vs. hemorrhage;
p
< 0.001), but also across different ischemic stroke subtypes (
p
= 0.025). The cumulative incidence rates of recurrent stroke at 28 days, 3 months and 1 year were 2.0% (95% CI 1.2–3.6%), 4.2% (2.8–6.2%) and 6.7% (5.1–8.8%), respectively. Comparable to other population-based surveys, our study reports 1-year mortality and stroke recurrence rates in patients with FES. These findings highlight the need for effective secondary prevention strategies in a border region of southeastern Europe, which exhibits very high FES incidence rates.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>30128708</pmid><doi>10.1007/s00415-018-9005-6</doi><tpages>9</tpages></addata></record> |
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| subjects | Health risk assessment Hemorrhage Ischemia Medicine Medicine & Public Health Mortality Neurology Neuroradiology Neurosciences Original Communication Population studies Stroke Subarachnoid hemorrhage |
| title | Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry |
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