Prognosis and disability of stroke patients after 5 years in Akita, Japan.

Abstract

The system of registering stroke patients was begun in 1963 in Ikawa Town, Akita Prefecture, Japan. The town is located in the northeastern part of the country and in 1975 had a population of 6,427. From 1975 to 1981, 109 patients who suffered their first stroke were registered and were monitored for 5 years. The average annual incidence rates of stroke were 2.8 and 2.0 per 1,000 population in males and females, respectively. Mean age at stroke onset was 63.3 and 71.4 years in males and females, respectively (p less than 0.01). According to the clinical classification of stroke, 76 patients suffered cerebral infarction, 21 cerebral bleeding, and six subarachnoid hemorrhage; six strokes were unclassified. The survival rates were compared by sex, age, and clinical stroke type using Cox's proportional hazards model. The survival rate of female stroke patients was lower than that of males, but not significantly so. The survival rate of stroke patients greater than or equal to 65 years old was significantly lower (p less than 0.01) than that of younger patients. Moreover, the survival rate of patients with cerebral bleeding was significantly lower (p less than 0.01) than that of patients with cerebral infarction. In the analysis of self-care among the survivors, performance of the activities of daily living in older patients indicated significantly less independence (p less than 0.01) in younger patients. Follow-up of new stroke cases showed that age and clinical stroke type were significantly associated with survival and that age was also related to disability of the survivors.