Independent predictors of mortality in subacute and chronic stroke patients: A single center study in Turkey

Abstract

BACKGROUND:

Although the long-term survival and related predictors have been identified in stroke patients, there is little evidence about the mortality rates and its associated factors in stroke patients treated in rehabilitation units.

OBJECTIVE:

To evaluate 5-year mortality rates of patients with stroke and its relationship with the clinical characteristics after inpatient subacute-chronic rehabilitation.

METHODS:

The files of 1016 stroke patients (482 male, 534 female) who received inpatient rehabilitation program were examined retrospectively. Patients’ characteristics and functional ambulation category were recorded at the end of the rehabilitation program. The survival probability was estimated using the Kaplan-Meier method and the univariate effects of predictors were determined using the log-rank test. The possible factors determined with univariate analyses were checked in the Cox regression analysis.

RESULTS:

A total of 273 patients (32%) died within 5 years after stroke. Age ( $p<$ 0.001, RR: 1.06, 95% CI: 1.05–1.08), presence of coronary artery disease ( $p=$ 0.003, RR: 1.53, 95% CI: 1.16–2.03) and poor walking ability ( $p<$ 0.001, RR: 2.06, 95% CI: 1.49–2.86) were independent prognostic factors for increased mortality.

CONCLUSIONS:

About one-third of the rehabilitation patients died within 5 years after stroke. As independent ambulation was a strong predictor for long-term survival, it should be provided via rehabilitation techniques. Future studies are proposed to determine the effects of rehabilitation methods on mortality rates.