Long-term mortality in cerebrovascular disease

Dawn M. Bravata, Shih Yieh Ho, Lawrence M. Brass, John Concato, Jeanne Scinto, Thomas P. Meehan

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)699-704
Number of pages6
JournalStroke
Volume34
Issue number3
DOIs
StatePublished - Mar 1 2003
Externally publishedYes

Keywords

  • Cerebral ischemia
  • Cohort studies
  • Mortality
  • Risk factors

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

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  • Cite this

    Bravata, D. M., Ho, S. Y., Brass, L. M., Concato, J., Scinto, J., & Meehan, T. P. (2003). Long-term mortality in cerebrovascular disease. Stroke, 34(3), 699-704. https://doi.org/10.1161/01.STR.0000057578.26828.78