Lacunar infarction, mortality over time and mortality relative to other ischemic strokes.

OBJECTIVES

Determine the overall mortality after lacunar infarction and compare it to the overall mortality afterothrombotic and cardioembolic strokes. Determine the pattern of increased mortality over time after lacunar infarction.

METHODS

The clinical literature was searched for articles providing mortality data on lacunar infarction having at least 5 years of post stroke follow up. Three such articles were identified two of which also had post stroke mortality data on the other two types of ischemic stroke, atherothrombotic and cardioembolic stroke. Degree of overall increased mortality was determined for all three stroke types and increased mortality over time was determined for lacunar infarction as well. Standard mortality methodology was used and expectant mortality was determined using appropriate population life tables. Average overall mortality ratios (MR) and average overall excess deaths per thousand per year (EDR) were determined by weighting for the number of entrants in each study.

RESULTS

The average overall MR for lacunar infarction = 159%, for atherothrombotic stroke = 213% and for cardioembolic stroke = 322%. The mortality ratios for lacunar infarction for the following post-stroke intervals were: 1-5 years = 166%; 6-10 years = 153%; and 11-14 years = 106%.

CONCLUSIONS

Lacunar infarction from onset is associated with moderately increased overall mortality relative to the general population. Post-stroke mortality risks from atherothrombotic and cardioembolic strokes are significantly higher.