One-year survival and prognostic factors for survival among stroke patients: The PROVEstroke study

Abstract

Background: Survival and prognostic factors following stroke occurrence differ between world regions. Studies investigating stroke features in the Middle?east region are scarce. We aimed to investigate 1?year survival and related prognostic factors of stroke patients in Central Iran. Materials and Methods: It is an observational analytical study conducted on patients registered in the Persian Registry of Cardiovascular Disease?Stroke  PROVE?Stroke) database. Records of 1703 patients admitted during  015–2016 with the primary diagnosis of stroke in all hospitals of Isfahan, Iran were reviewed. Information regarding sociodemographic  haracteristics, clinical presentations, medications, and comorbidities were recorded. The living status of patients after 1 year from stroke was considered as 1?year survival. Results: Among 1345 patients with the final diagnosis of stroke, 970 (72.1%) were alive at the 1 year follow?up and the mean survival time based on Kaplan–Meier procedure was estimated 277.33 days. The hemorrhagic and ischemic types of stroke were reported in 201 (15.0%) and 1141 (84.8%) patients, respectively. Age  hazard ratio [HR] = 1.07, 95% confidence interval [CI] =  .05–1.09), diabetes (HR = 1.49, 95% CI = 1.07–2.06), history of stroke or transient ischemic attack (HR = 1.81, 95% CI = 1.30–2.52), history of warfarin usage (HR = 1.73, 95% CI = 1.11–2.71), hospital complications of hemorrhage (HR = 3.89, 95% CI = 2.07–7.31), sepsis (HR = 1.78, 95% CI = 1.18–2.68), and hydrocephalus (HR = 3.43, 95% CI =  .34–8.79), and modified Rankin Scale (mRS) ?3 at the time of hospital dicharge (HR = 1.98, 95% CI = 1.27–3.07), were predictors of 1?year survival.  onclusion: Predictors of 1?year survival can be categorized into  changeable ones, such as age, diabetes, previous stroke, and mRS. The changeable factors, such as hospital complications of infection and  emorrhage, guide physicians to pay greater attention to reduce the risk of mortality following stroke.