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Risks of Stroke Recurrence and Mortality After First and Recurrent Strokes in Denmark: A Nationwide Registry Study
Neurology ( IF 9.9 ) Pub Date : 2022-01-25 , DOI: 10.1212/wnl.0000000000013118
Nils Skajaa 1, 2 , Kasper Adelborg 3, 4 , Erzsébet Horváth-Puhó 3 , Kenneth J Rothman 3, 5, 6 , Victor W Henderson 3, 7, 8 , Lau Caspar Thygesen 2 , Henrik Toft Sørensen 3, 5, 7
Affiliation  

Background and Objectives

To examine risks of stroke recurrence and mortality after first and recurrent stroke.

Methods

Using Danish nationwide health registries, we included patients age ≥18 years with first-time ischemic stroke (n = 105,397) or intracerebral hemorrhage (ICH) (n = 13,350) from 2004 to 2018. Accounting for the competing risk of death, absolute risks of stroke recurrence were computed separately for each stroke subtype and within strata of age groups, sex, stroke severity, body mass index, smoking, alcohol use, Essen stroke risk score, and atrial fibrillation. Mortality risks were computed after first and recurrent stroke.

Results

After adjusting for competing risks, the overall 1-year and 10-year risks of recurrence were 4% and 13% following first-time ischemic stroke and 3% and 12% following first-time ICH. For ischemic stroke, the risk of recurrence increased with age and was higher for men and following mild vs more severe stroke. The most marked differences were across Essen risk scores, for which recurrence risks increased with increasing scores. For ICH, risks were similar for both sexes and did not increase with Essen risk score. For ischemic stroke, the 1-year and 10-year risks of all-cause mortality were 17% and 56% after a first-time stroke and 25% and 70% after a recurrent stroke; corresponding estimates for ICH were 37% and 70% after a first-time event and 31% and 75% after a recurrent event.

Discussion

The risk of stroke recurrence was substantial following both subtypes, but risks differed markedly among patient subgroups. The risk of mortality was higher after a recurrent than first-time stroke.



中文翻译:

丹麦首次和复发性中风后中风复发和死亡的风险:一项全国性登记研究

背景和目标

检查首次和复发性卒中后卒中复发和死亡率的风险。

方法

使用丹麦全国健康登记,我们纳入了 2004 年至 2018 年年龄≥18 岁的首次缺血性卒中(n = 105,397)或脑出血(ICH)(n = 13,350)的患者。考虑到死亡的竞争风险,绝对风险中风复发率分别针对每个中风亚型和年龄组、性别、中风严重程度、体重指数、吸烟、饮酒、埃森中风风险评分和心房颤动分层计算。在第一次和复发性中风后计算死亡风险。

结果

调整竞争风险后,首次缺血性卒中后 1 年和 10 年的总体复发风险分别为 4% 和 13%,首次 ICH 后分别为 3% 和 12%。对于缺血性中风,复发风险随着年龄的增长而增加,男性和轻度中风与重度中风的复发风险更高。最显着的差异是埃森风险评分,复发风险随着评分的增加而增加。对于 ICH,两性的风险相似,并且没有随着 Essen 风险评分的增加而增加。对于缺血性卒中,首次卒中后 1 年和 10 年全因死亡风险分别为 17% 和 56%,复发性卒中后分别为 25% 和 70%;首次事件后 ICH 的相应估计值分别为 37% 和 70%,复发事件后分别为 31% 和 75%。

讨论

两种亚型的卒中复发风险都很大,但患者亚组之间的风险显着不同。复发后的死亡风险高于首次中风。

更新日期:2022-01-25
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