RISK FACTORS IMPACT ON THE LONG-TERM SURVIVAL AFTER ISCHEMIC STROKE

INTRODUCTION: Stroke is the second or third cause on a mortality list, and all projections indicate that this will remain in the year 2020. Furthermore, stroke is a leading cause of disability. A number of risk factors have been shown to be associated with stroke: age, sex, hypertension, diabetes mellitus, smoking, history of cardiac diseases, and past history of transient ischemic attack. AIM: To analyze the impact of risk factors on the survival rate within a period of five years after ischemic stroke (IS). PATIENTS AND METHODS: In this study 613 patients were analyzed with a first ever ischemic stroke admitted at the Department of Neurology Tuzla, from January 1st 1997 to December 31st 1998. Data were collected from patient medical records when they were admitted to the hospital. The final examination of patients, who survived IS, took place five years after stroke. Medical history was obtained and presence of risk factors was evaluated on the day of admission. Computed tomography (CT) of the brain was performed for all patients during hospitalization. RESULTS: The average age of patients was 65 ± 10 (from 31 to 90) years, 333 (53%) were women. The most frequent risk factor was heart diseases which is registered in 525 (85.5%) patients, followed with history of hypertension in 419 patients (68%), cigarette smoking in 172 (28%), past history of transient ischemic attack in 168 (27%) and diabetes mellitus in 116 (19%). The risk factors were not registered in 1 (0.1%) patients. Five years after ischemic stroke 188 (31%) patients were survived. No statistical significance was occurred related to survival between men and women (p=0.4). The lowest number of patient that survived were over 70 years old 19 (10%), while the highest number of survived was between 41-50 years 30(60%). The average number of risk factors was 2.65± 1.0 and significantly higher in men compared to women (2.7 ± 1: 2.3 ± 1) (p<0.001). Significant difference was found in patients related to the existence of heart diseases (525 with compared to 88 without) (p <0.001), hypertension (with 419; without 194) (p<0.003), diabetes mellitus (with 116; without 497) (p=0.04) and cigarette smoking (with172; without 441) (p<0.001). Concerning transient ischemic attack there were no significant difference in survival in patients with ischemic stroke (p=0.7). CONCLUSION: The survival rate after ischemic stroke was 31% within a period of five years. Long-term survival rate prognosis was significantly better in the younger patients, with no heart diseases, hypertension, and diabetes mellitus as well as in cigarette non-smokers.