Kielbergerová Lenka, Mayer Otto, Bruthans Jan
Vnitr Lek. 2022 Fall;68(E-3):4-11.
Stroke represents an essential part of the burden of cardiovascular diseases. Despite specific mortality from cerebrovascular diseases decreasing in the Czech Republic since the 80s, the trends in case fatality and individual risk of patients who suffered from stroke remain questionable. In patients hospitalized for ischemic stroke, we evaluated the mortality trends in the last two decades.
9076 patients (mean age 71.8, 51.9% males) hospitalized for ischemic stroke between 2003 and 2019 were followed. The vital status we ascertained up to 31.12.2020, other circumstances from the hospital information system Results: In total, 5583 patients died during follow-up. The in-hospital fatality was 9.1%, 30-day mortality 14.2%, and 1-year mortality 28.4%. In patients hospitalized from 2003 to 2015, the 5-year mortality was 49.8%. No significant changes were noted for in-hospital fatality, 30-days, 1-year mortality, as well as 5-years mortality risk across more extensive periods (2003-07, 2008-11, 2012-15 and 2016-19). As expected, any decade of patient´s age was associated with about two-fold higher mortality risk. Intravenous thrombolysis, as part of initial management, markedly increased over time (from 2.4% in 2003-07 to 48.1% in 2016-19). However, this procedure affected beneficially only 1-year mortality risk, while regarding 5-years mortality was its effect neutral.
Despite favorable trends in cerebrovascular events from a population perspective, the individual prognosis of patients who have suffered a stroke remains very poor.
中风是心血管疾病负担的重要组成部分。尽管自80年代以来捷克共和国脑血管疾病的特定死亡率有所下降,但中风患者的病死率趋势和个体风险仍存在疑问。我们评估了过去二十年中因缺血性中风住院患者的死亡率趋势。
对2003年至2019年间因缺血性中风住院的9076例患者(平均年龄71.8岁,男性占51.9%)进行随访。我们确定了截至2020年12月31日的生命状态,其他情况来自医院信息系统。结果:在随访期间,共有5583例患者死亡。住院病死率为9.1%,30天死亡率为14.2%,1年死亡率为28.4%。在2003年至2015年住院的患者中,5年死亡率为49.8%。在更长的时间段(2003 - 07年、2008 - 11年、2012 - 15年和2016 - 19年)内,住院病死率、30天、1年死亡率以及5年死亡风险均未发现显著变化。正如预期的那样,任何十年年龄段的患者死亡风险都高出约两倍。作为初始治疗的一部分,静脉溶栓治疗随时间显著增加(从2003 - 07年的2.4%增至2016 - 19年的48.1%)。然而,该治疗仅对1年死亡风险有有益影响,而对5年死亡率的影响为中性。
尽管从人群角度看脑血管事件呈有利趋势,但中风患者的个体预后仍然很差。