Abstract MP080: Trends in Nine-year Survival of Stroke Patients between 1980 and 2000 The Minnesota Stroke Survey
Background: There have been numerous advances in stroke care over the past 30 years. We examined early and long-term stroke survival over this period to learn if these advances were associated with improved outcomes.
Methods: Data for years 1980, 1985, 1990, 1995, and 2000 were obtained from the Minnesota Stroke Survey, a population-based surveillance of hospitalized acute stroke patients aged 30-74 years in the Minneapolis-St. Paul metropolitan area. Cases with an acute stroke hospital discharge code (ICD-9-CM 431, 432, 434, 436, 437) and a new neurological deficit of vascular origin lasting at least 24 hours or until death were selected (n= 3,737). Non-stroke etiologies were excluded. Cases were sub-typed as ischemic (IS) (n=1,638) or hemorrhagic strokes (HS) (n=485) for years 1990, 1995, and 2000 by neuroimaging. Mortality was obtained by linkage to the Department of Health vital statistics. We report 30 day, 1 year, and 9 year age-adjusted post-stroke survival.
Results: All stroke: Survival improved from 1980 to 2000 (Table). Early (30 day) survival improved (men 78% to 86%, p=0.003; women 79% to 88%, p=0.001) as did long-term (9 year) survival (men 33% to 49%, p=<0.001; women 35% to 53%, p<0.001). Long-term survival gains were not simply due to early survival improvements as shown by increased post 30-day and post-1-year survival (Table). Stroke Subtypes: Early (30 day) IS survival did not improve significantly from 1990 to 2000 (men 88% to 90%, p=0.56; women 87% to 92%, p=0.08) and neither did 30 day HS survival (men 61% to 69%, p=0.39; women 63% to 69%, p=0.38). For IS, 9-year survival improved (men 39% to 53%, p<0.001; women 43% to 59%, p<0.001). For HS, 9 year survival improved in men (men 29% to 48%, p=0.03; women 44% to 51%, p=0.34).
Conclusion: Early and long-term stroke survival improved between 1980 and 2000. Improved long-term survival was not merely due to improved early survival. Long-term survival improved for IS in both sexes. Small samples sizes may explain the lack of significant improvements in HS survival in women.
|Age Adjusted Survival, %|
|1-year survival among 30-day survivors||86.5||85.3||88.5||91||91.9||0.002|
|9-year survival among 1 year survivors||48.2||47.3||51.1||57.5||62.3||<0.001|
|1-year survival among 30-day survivors||81.2||87.6||85.5||87||90.4||0.005|
|9-years survival among 1 year survivors||54.5||63.1||57.7||57.4||67.3||0.040|
- © 2012 by American Heart Association, Inc.