London, United Kingdom 2013 4 Stroke prognosis 9:00 - 9:10 Living alone prior to index stroke predicts poor long-term post-stroke outcome: the Sahl-grenska Academy Study on Ischemic Stroke Outcome P. Redfors1, D. Isaksén2, L. Holmegaard3, C. Blomstrand4, A. Rosengren5, K. Jood6, C. Jern7 Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Go-thenburg, Gothenburg, SWEDEN1,Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, SWEDEN2, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, SWEDEN3, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothen-burg, Gothenburg, SWEDEN4, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, SWEDEN5, Institute of Neuroscience and Physiology, the Sahlgrens-ka Academy at University of Gothenburg, Gothenburg, SWEDEN6, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, SWE-DEN7 Background: Studies on recurrent vascular events and their prognostic factors in a long-term perspective after ischemic stroke are limited. We aimed to explore the potential impact on prog-nosis Cerebrovasc Dis 2013; 35 (suppl 3)1-854 17 for baseline social factors. Methods: As part of the Sahlgrenska Study on Ischemic Stroke Outcome, 600 consecutive pa-tients with ischemic stroke before 70 years of age and 600 age- and sex-matched controls were prospectively followed. Participants were characterized in detail at baseline. Data on recurrent vascular events and mortality were collected through national registers and medical records. We used Cox regression models for identifying predictors of outcome. Results: Mean follow-up was 8.6 (SD 2.1) years. No participant was lost to follow-up. Among cases, the cumulative event rate was 31% for any vascular event and/or vascular death (com-bined outcome), 20% for recurrent stroke, 8.8% for coronary events and 19% for all-cause mor-tality. These event rates were substantially lower for controls; combined outcome 9.3%, stroke 1.5%, coronary events 3.2% and mortality 5.7% (all P<0.001 compared to cases). In cases, dia-betes (hazard ratio 1.5, 95% confidence interval 1.1-2.1), smoking (1.4, 1.0-1.9), waist hip ratio (15, 1.3-170), history of coronary disease (1.8, 1.4-3.9), the subtype of large vessel disease (1.9, 1.2-3.2), cardioembolic stroke (1.7, 1.0-2.9), living alone (1.5, 1.1-2.2) and high alcohol con-sumption (1.7, 1.0-2.8) predicted the combined outcome, independently of age, stroke severity and socioeconomic status. Living alone was also an independent predictor of recurrent stroke and all-cause mortality (P<0.001 for both), but not of coronary events. Conclusion: Young and middle-aged ischemic stroke sufferers have a considerable increased risk of death and recurrent vascular events also in a long-term perspective. Together with more established prognostic factors, living alone prior to index stroke emerged as an important pre-dictor of poor post-stroke outcome. Figure. Non parametric cumulative incidence functions for cardiac events (fatal and non-fatal myocardial infarction), cerebral events (fatal and non-fatal ischemic stroke) and death. Solid and dashed lines represent participants without headache and with headache respectively.
Karger_ESC London_2013
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