Ten-year prognosis of stroke and risk factors for death in a Japanese community

The Hisayama study

Yutaka Kiyohara, Michiaki Kubo, Isao Kato, Yimihiro Tanizaki, Keiichi Tanaka, Ken Okubo, Hidetoshi Nakamura, Mitsuo Iida

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Background and Purpose - There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort. Methods - During a 26-year follow-up of a cohort of 1621 subjects ≥40 years of age, 333 subjects developed first-ever stroke and were prospectively followed up for 10 years after onset. During these 10-year follow-up periods, 268 of the 333 stroke patients died. Of those, 239 (89.2%) underwent autopsy. Results - The risk of death was greatest in the first year after first-stroke onset in both sexes (men, 40.3%; women, 43.7%). Thereafter, the survival curves decreased gradually, and risk of death reached 80.7% for men and 80.2% for women by the end of the 10-year follow-up. The 30-day case fatality rate was substantially greater in patients with cerebral hemorrhage (63.3%) or subarachnoid hemorrhage (58.6%) than in patients with cerebral infarction (9.0%). The risk of dying after the first stroke was twice the risk for stroke-free subjects. The most common cause of death was the index stroke in the first year. Thereafter, the impact of the first stroke gradually decreased, while that of recurrent stroke increased. Multivariate analysis revealed that age, lower body mass index, and hemorrhagic stroke were significant risk factors for death after stroke. Conclusions - Our findings suggest that the risk of death after first-ever stroke is high, in part because of the larger proportion of hemorrhagic stroke in Japanese relative to stroke victims in Western countries.

Original languageEnglish
Pages (from-to)2343-2347
Number of pages5
JournalStroke
Volume34
Issue number10
DOIs
Publication statusPublished - 01-10-2003

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Stroke
Cerebral Infarction
Cerebral Hemorrhage
Subarachnoid Hemorrhage
Cause of Death
Autopsy
Body Mass Index
Cohort Studies
Multivariate Analysis
Survival
Mortality

All Science Journal Classification (ASJC) codes

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

Cite this

Kiyohara, Yutaka ; Kubo, Michiaki ; Kato, Isao ; Tanizaki, Yimihiro ; Tanaka, Keiichi ; Okubo, Ken ; Nakamura, Hidetoshi ; Iida, Mitsuo. / Ten-year prognosis of stroke and risk factors for death in a Japanese community : The Hisayama study. In: Stroke. 2003 ; Vol. 34, No. 10. pp. 2343-2347.
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abstract = "Background and Purpose - There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort. Methods - During a 26-year follow-up of a cohort of 1621 subjects ≥40 years of age, 333 subjects developed first-ever stroke and were prospectively followed up for 10 years after onset. During these 10-year follow-up periods, 268 of the 333 stroke patients died. Of those, 239 (89.2{\%}) underwent autopsy. Results - The risk of death was greatest in the first year after first-stroke onset in both sexes (men, 40.3{\%}; women, 43.7{\%}). Thereafter, the survival curves decreased gradually, and risk of death reached 80.7{\%} for men and 80.2{\%} for women by the end of the 10-year follow-up. The 30-day case fatality rate was substantially greater in patients with cerebral hemorrhage (63.3{\%}) or subarachnoid hemorrhage (58.6{\%}) than in patients with cerebral infarction (9.0{\%}). The risk of dying after the first stroke was twice the risk for stroke-free subjects. The most common cause of death was the index stroke in the first year. Thereafter, the impact of the first stroke gradually decreased, while that of recurrent stroke increased. Multivariate analysis revealed that age, lower body mass index, and hemorrhagic stroke were significant risk factors for death after stroke. Conclusions - Our findings suggest that the risk of death after first-ever stroke is high, in part because of the larger proportion of hemorrhagic stroke in Japanese relative to stroke victims in Western countries.",
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Kiyohara, Y, Kubo, M, Kato, I, Tanizaki, Y, Tanaka, K, Okubo, K, Nakamura, H & Iida, M 2003, 'Ten-year prognosis of stroke and risk factors for death in a Japanese community: The Hisayama study', Stroke, vol. 34, no. 10, pp. 2343-2347. https://doi.org/10.1161/01.STR.0000091845.14833.43

Ten-year prognosis of stroke and risk factors for death in a Japanese community : The Hisayama study. / Kiyohara, Yutaka; Kubo, Michiaki; Kato, Isao; Tanizaki, Yimihiro; Tanaka, Keiichi; Okubo, Ken; Nakamura, Hidetoshi; Iida, Mitsuo.

In: Stroke, Vol. 34, No. 10, 01.10.2003, p. 2343-2347.

Research output: Contribution to journalArticle

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T1 - Ten-year prognosis of stroke and risk factors for death in a Japanese community

T2 - The Hisayama study

AU - Kiyohara, Yutaka

AU - Kubo, Michiaki

AU - Kato, Isao

AU - Tanizaki, Yimihiro

AU - Tanaka, Keiichi

AU - Okubo, Ken

AU - Nakamura, Hidetoshi

AU - Iida, Mitsuo

PY - 2003/10/1

Y1 - 2003/10/1

N2 - Background and Purpose - There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort. Methods - During a 26-year follow-up of a cohort of 1621 subjects ≥40 years of age, 333 subjects developed first-ever stroke and were prospectively followed up for 10 years after onset. During these 10-year follow-up periods, 268 of the 333 stroke patients died. Of those, 239 (89.2%) underwent autopsy. Results - The risk of death was greatest in the first year after first-stroke onset in both sexes (men, 40.3%; women, 43.7%). Thereafter, the survival curves decreased gradually, and risk of death reached 80.7% for men and 80.2% for women by the end of the 10-year follow-up. The 30-day case fatality rate was substantially greater in patients with cerebral hemorrhage (63.3%) or subarachnoid hemorrhage (58.6%) than in patients with cerebral infarction (9.0%). The risk of dying after the first stroke was twice the risk for stroke-free subjects. The most common cause of death was the index stroke in the first year. Thereafter, the impact of the first stroke gradually decreased, while that of recurrent stroke increased. Multivariate analysis revealed that age, lower body mass index, and hemorrhagic stroke were significant risk factors for death after stroke. Conclusions - Our findings suggest that the risk of death after first-ever stroke is high, in part because of the larger proportion of hemorrhagic stroke in Japanese relative to stroke victims in Western countries.

AB - Background and Purpose - There have been very few population-based cohort studies of long-term prognosis and risk factors for death after stroke. We examined the 10-year prognosis, causes, and risk factors of death after stroke in a Japanese cohort. Methods - During a 26-year follow-up of a cohort of 1621 subjects ≥40 years of age, 333 subjects developed first-ever stroke and were prospectively followed up for 10 years after onset. During these 10-year follow-up periods, 268 of the 333 stroke patients died. Of those, 239 (89.2%) underwent autopsy. Results - The risk of death was greatest in the first year after first-stroke onset in both sexes (men, 40.3%; women, 43.7%). Thereafter, the survival curves decreased gradually, and risk of death reached 80.7% for men and 80.2% for women by the end of the 10-year follow-up. The 30-day case fatality rate was substantially greater in patients with cerebral hemorrhage (63.3%) or subarachnoid hemorrhage (58.6%) than in patients with cerebral infarction (9.0%). The risk of dying after the first stroke was twice the risk for stroke-free subjects. The most common cause of death was the index stroke in the first year. Thereafter, the impact of the first stroke gradually decreased, while that of recurrent stroke increased. Multivariate analysis revealed that age, lower body mass index, and hemorrhagic stroke were significant risk factors for death after stroke. Conclusions - Our findings suggest that the risk of death after first-ever stroke is high, in part because of the larger proportion of hemorrhagic stroke in Japanese relative to stroke victims in Western countries.

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