TY - JOUR
TI - Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry
AU - Tsivgoulis, G.
AU - Katsanos, A.H.
AU - Patousi, A.
AU - Pikilidou, M.
AU - Birbilis, T.
AU - Mantatzis, M.
AU - Yavropoulou, M.
AU - Zompola, C.
AU - Triantafyllou, S.
AU - Papanas, N.
AU - Skendros, P.
AU - Terzoudi, A.
AU - Georgiadis, G.S.
AU - Zebekakis, P.
AU - Maltezos, E.
AU - Piperidou, C.
AU - Heliopoulos, I.
AU - Vadikolias, K.
JO - Egyptian Journal of Neurology, Psychiatry and Neurosurgery
PY - 2018
VL - 265
TODO - 10
SP - 2379-2387
PB - Dr. Dietrich Steinkopff Verlag GmbH and Co. KG
SN - null
TODO - 10.1007/s00415-018-9005-6
TODO - adult;  age;  aged;  Article;  brain hemorrhage;  brain ischemia;  cerebrovascular accident;  comparative study;  controlled study;  disease registry;  female;  follow up;  Greece;  health survey;  human;  hypertension;  incidence;  major clinical study;  male;  medical history;  mortality;  mortality rate;  mortality risk;  priority journal;  prospective study;  recurrence risk;  recurrent disease;  risk assessment;  stroke patient;  stroke survivor;  subarachnoid hemorrhage;  cerebrovascular accident;  Greece;  middle aged;  recurrent disease;  very elderly, Adult;  Aged;  Aged, 80 and over;  Brain Ischemia;  Cerebral Hemorrhage;  Female;  Follow-Up Studies;  Greece;  Humans;  Incidence;  Male;  Middle Aged;  Prospective Studies;  Recurrence;  Stroke;  Subarachnoid Hemorrhage
TODO - 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. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature.
ER -