Stroke recurrence and mortality in northeastern Greece

the Evros Stroke Registry

Georgios Tsivgoulis, Aristeidis H. Katsanos, Athanasia Patousi, Maria Pikilidou, Theodosis Birbilis, Michael Mantatzis, Maria Yavropoulou, Christina Zompola, Sokratis Triantafyllou, Nikolaos Papanas, Panagiotis Skendros, Aikaterini Terzoudi, George S. Georgiadis, Pantelis Zebekakis, Efstratios Maltezos, Charitomeni Piperidou, Ioannis Heliopoulos, Konstantinos Vadikolias

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Up to date there is no population-based study from Greece providing long-term data on incidence of both all-cause mortality and stroke recurrence for patients with first ever stroke (FES). Adult patients with FES were registered during a 24-month period (2010–2012) and followed-up for 12 months. We calculated cumulative incidences of stroke mortality and recurrence. Univariable and multivariable Cox proportional hazards regression analyses were used to identify independent determinants of 1-year mortality and 1-year stroke recurrence. We prospectively documented 703 first ever stroke cases (mean age 75 ± 12 years; 52.8% males; ischemic stroke 80.8%, intracerebral hemorrhage 11.8%, subarachnoid hemorrhage 4.4%, undefined 3.0%) with a total follow-up time of 119,805 person-years. The cumulative incidence rates of mortality of all FES patients at 28 days, 3 months and 1 year were 21.3% (95% CI 18.5–24.5%), 26% (95% CI 22.9–29.4%) and 34.7% (95% CI 31.3–38.3%), respectively. The risk of 1-year mortality was independently (p < 0.05) associated with advancing age, history of hypertension, increased stroke severity on admission, and hemorrhagic FES type. Cumulative 1-year stroke mortality differed according to both index FES type (ischemic vs. hemorrhage; p < 0.001), but also across different ischemic stroke subtypes (p = 0.025). The cumulative incidence rates of recurrent stroke at 28 days, 3 months and 1 year were 2.0% (95% CI 1.2–3.6%), 4.2% (2.8–6.2%) and 6.7% (5.1–8.8%), respectively. Comparable to other population-based surveys, our study reports 1-year mortality and stroke recurrence rates in patients with FES. These findings highlight the need for effective secondary prevention strategies in a border region of southeastern Europe, which exhibits very high FES incidence rates.

Original languageEnglish (US)
Pages (from-to)2379-2387
Number of pages9
JournalJournal of Neurology
Volume265
Issue number10
DOIs
StatePublished - Oct 1 2018
Externally publishedYes

Fingerprint

Greece
Registries
Stroke
Recurrence
Mortality
Incidence
Cerebral Hemorrhage
Subarachnoid Hemorrhage
Secondary Prevention

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Tsivgoulis, G., Katsanos, A. H., Patousi, A., Pikilidou, M., Birbilis, T., Mantatzis, M., ... Vadikolias, K. (2018). Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry. Journal of Neurology, 265(10), 2379-2387. https://doi.org/10.1007/s00415-018-9005-6

Stroke recurrence and mortality in northeastern Greece : the Evros Stroke Registry. / Tsivgoulis, Georgios; Katsanos, Aristeidis H.; Patousi, Athanasia; Pikilidou, Maria; Birbilis, Theodosis; Mantatzis, Michael; Yavropoulou, Maria; Zompola, Christina; Triantafyllou, Sokratis; Papanas, Nikolaos; Skendros, Panagiotis; Terzoudi, Aikaterini; Georgiadis, George S.; Zebekakis, Pantelis; Maltezos, Efstratios; Piperidou, Charitomeni; Heliopoulos, Ioannis; Vadikolias, Konstantinos.

In: Journal of Neurology, Vol. 265, No. 10, 01.10.2018, p. 2379-2387.

Research output: Contribution to journalArticle

Tsivgoulis, G, Katsanos, AH, Patousi, A, Pikilidou, M, Birbilis, T, Mantatzis, M, Yavropoulou, M, Zompola, C, Triantafyllou, S, Papanas, N, Skendros, P, Terzoudi, A, Georgiadis, GS, Zebekakis, P, Maltezos, E, Piperidou, C, Heliopoulos, I & Vadikolias, K 2018, 'Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry', Journal of Neurology, vol. 265, no. 10, pp. 2379-2387. https://doi.org/10.1007/s00415-018-9005-6
Tsivgoulis G, Katsanos AH, Patousi A, Pikilidou M, Birbilis T, Mantatzis M et al. Stroke recurrence and mortality in northeastern Greece: the Evros Stroke Registry. Journal of Neurology. 2018 Oct 1;265(10):2379-2387. https://doi.org/10.1007/s00415-018-9005-6
Tsivgoulis, Georgios ; Katsanos, Aristeidis H. ; Patousi, Athanasia ; Pikilidou, Maria ; Birbilis, Theodosis ; Mantatzis, Michael ; Yavropoulou, Maria ; Zompola, Christina ; Triantafyllou, Sokratis ; Papanas, Nikolaos ; Skendros, Panagiotis ; Terzoudi, Aikaterini ; Georgiadis, George S. ; Zebekakis, Pantelis ; Maltezos, Efstratios ; Piperidou, Charitomeni ; Heliopoulos, Ioannis ; Vadikolias, Konstantinos. / Stroke recurrence and mortality in northeastern Greece : the Evros Stroke Registry. In: Journal of Neurology. 2018 ; Vol. 265, No. 10. pp. 2379-2387.
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AU - Birbilis, Theodosis

AU - Mantatzis, Michael

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