Two-Year Survival After First-Ever Stroke in a General Population of 1.4 Million Japanese - Shiga Stroke Registry

Circ J. 2018 Sep 25;82(10):2549-2556. doi: 10.1253/circj.CJ-18-0346. Epub 2018 Jul 27.

Abstract

Background: Stroke is one of the leading causes of disability and mortality in Japan. The aim of the present analysis was to determine the non-acute survival rate after first-ever stroke using data from a large-scale population-based stroke registry in Japan. Methods and Results: Shiga Stroke Registry is an ongoing population-based registry of stroke, which covers approximately 1.4 million residents of Shiga Prefecture in central Japan. A total of 2,176 first-ever stroke patients, who were registered in 2011, were followed up until December 2013. The 2-year cumulative survival rates were estimated using Kaplan-Meier method according to index stroke subtype. Cox proportional hazards models were used to assess predictors of all-cause death. During a 2-year follow-up period, 663 patients (30.5%) died. The 2-year cumulative survival rate after first-ever stroke was 69.5%. There was heterogeneity in 2-year cumulative survival according to stroke subtype: lacunar infarction, 87.2%; large artery infarction, 76.1%; cardioembolic infarction, 55.4%; intracerebral hemorrhage, 65.9%; and subarachnoid hemorrhage, 56.7%. Older age, male sex, medical history, higher Japan coma scale score on admission, and stroke subtype were associated with risk of all-cause death in ≤2 years.

Conclusions: In the present population-based stroke registry with a real-world setting in Japan, 2-year cumulative mortality after first-ever stroke is still high (>30%), particularly for cardioembolic infarction, subarachnoid hemorrhage and intracerebral hemorrhage.

Keywords: Asia; General population; Stroke; Survival rate.

MeSH terms

  • Age Factors
  • Brain Infarction
  • Cerebral Hemorrhage
  • Japan / epidemiology
  • Proportional Hazards Models
  • Registries
  • Risk Factors
  • Sex Factors
  • Stroke / epidemiology
  • Stroke / mortality*
  • Stroke / pathology
  • Stroke, Lacunar
  • Survival Analysis