Prognosis and Quality of Survival in a Hospitalized Stroke Population From the South

Abstract

Likelihood and quality of survival were assessed for patients (79% blacks) consecutively admitted to a southern teaching hospital stroke unit. The functional condition of 260 patients in eight categories of cerebrovascular disease was determined at discharge and three years later. Cumulative probability of five-year survival was calculated for 400 patients and compared to the population at large. Clinical variables were related to the prognosis in 155 patients with anterior circulation infarction. Mortality during hospitalization varied from 8% to 52%. More than half of the patients in most diagnostic groups died within three years of their stroke. Only 22% of patients with anterior circulation infarcts were fully ambulatory three years later. Prognosis worsened markedly with age and known pre-existing hypertension, and survival was decreased in blacks and in men. Overall five-year survival probability for all stroke patients discharged alive was 49%. Survival was similar in patients discharged ambulatory with or without aid, but poor in patients not ambulatory at discharge. Less than half as many individuals in the anterior circulation infarct group survived five years than did in the general population. The prognosis for blacks was even somewhat worse when compared to the black population at large.