Factors associated with long-term mortality for stroke unit patients in Latvia

Abstract

Aim: The aim of this study was to evaluate how pre-stroke risk factors, neurological symptoms, and the level of disability shortly after stroke are associated with poststroke mortality during a 7-year period after stroke, for persons treated in a stroke unit.

Methods: The data of 231 patients were included in the study. Patients who were treated in the stroke unit at the Riga East University Hospital between February 1, 2009, and July 20, 2009, were included in this study. Three stepwise Cox proportional hazard analyses were performed to analyze mortality in the 7 years following stroke. Pre-stroke risk factors (type of stroke, arterial hypertension, diabetes mellitus, atrial fibrillation, smoking, alcohol abuse, obesity, recurrent stroke, age, gender), neurological symptoms (motor deficit, sensory disturbance, aphasia, poststroke urinary incontinence (PSUI), mental status), and limitations of activity (feeding, bathing, grooming, dressing, toilet use, transfers, mobility, stairs) were evaluated as factors associated with mortality after stroke.

Results: A total of 145 (62.8%) patients died during the study period. The final model for each group of factors included only one of the factors used for the analysis. Patients who had alcohol abuse were 40% more likely to die earlier. The hazard for those with PSUI is 1.72 times higher than those without PSUI. The independence in grooming showed a 39% lower likelihood of dying earlier.

Conclusion: Alcohol abuse as a pre-stroke risk factor, poststroke urinary incontinence as a neurological symptom, and dependence in grooming as a factor of disability were associated with earlier mortality in the first seven years after stroke.

Keywords: disability; mortality; neurological symptoms; risk factors; stroke.

Figure 1

The cumulative survival curves for significant factors influencing mortality: alcohol abuse (a), poststroke urinary incontinence (b), and grooming (c)