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National Audit Programme show that 13.6% of people admitted to hospital with
stroke in England and Wales died (either in hospital or after being discharged
from inpatient care) within 30 days (1)
- there are approximately 1.2 million stroke survivors in the UK. The risk
of recurrent stroke is 26% within 5 years of a first stroke and 39% by 10
There is an approximate 40% complete recovery rate.
The majority of recovery of function - for example from hemiparesis - occurs in
the first week. Any deficit remaining at 1 month is likely to be permanent. However,
this is not to say that the disabilities caused by these impairments are unsurmountable
at this stage - rehabilitation can continue for a long while.
of event happening determines the prognosis. After infarcts there is a 23% fatality
at 12 months, and of the survivors, 65% have an independent existence. With primary
intracranial haemorrhage the figures are 62% and 68% respectively; for subarachnoid
haemorrhage it is 48% and 76%.
Mortality and morbidity vary with type of ischaemic stroke (2):
- atherosclerotic - mortality at 5 years 32.2%;
good function at 1 year 53.4%; recurrent stroke at 5 years 40.2%
cardioembolic - mortality at 5 years 80.2%; good function at 1 year 26.7%; recurrent
stroke at 5 years 31.7%
- lacunar - mortality at 5 years 35.1%;
good function at 1 year 81.9%; recurrent stroke at 5 years 24.8%
Another study also examined the risk of recurrent stroke (3) versus the risk
of a first-ever stroke:
- over 10 years of follow-up, the risk of first recurrent
stroke is 6 times greater than the risk of first-ever stroke in the general population
of the same age and sex, almost one half of survivors remain disabled, and one
seventh require institutional care
In severe strokes the patient
may need to be accommodated in a rehabilitation centre for intensive rehabilitative
therapy. There is evidence that care given by a specialist multidisciplinary team
(stroke unit) reduces mortality and institutionalisation compared with routine
care in general medical wards.
- a systematic review revealed risks for myocardial infarction or non-stroke
vascular death after ischaemic stroke were each 2% per year
- NICE (May 2019).Stroke
and transient ischaemic attack in over 16s: diagnosis and initial management
- Petty GW et al. Ischaemic stroke subtypes. A population-based study of functional
outcome, survival and recurrence. Stroke 2000; 31: 1062-8.
K et al. Ten-year risk of first recurrent stroke and disability after first-ever
stroke in the Perth Community Stroke Study. Stroke 2004;35:731-5
E et al. Risk of myocardial infarction and vascular death after transient
ischemic attack and ischemic stroke: a systematic review and meta-analysis.
Last edited 06/2019