Stroke survival rates
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Stroke Survival Rates: Global and Long-Term Perspectives
Short-Term and Long-Term Survival Rates After Stroke
Survival rates after a stroke vary significantly depending on the time since the event and the type of stroke. In Denmark, the risk of death after a first stroke was 28% at 28 days, 41% at 1 year, and 60% at 5 years, with the highest risk in the acute and subacute phases. Compared to the general population, stroke survivors had a much higher risk of death, especially in the first year after the event, and this excess risk persisted over time, mainly due to cardiovascular causes but also other diseases and accidents .
Large-scale studies in Australia and New Zealand found that survival probabilities were 79.5% at 3 months, 73.0% at 1 year, 52.8% at 5 years, and 38.8% at 9 years after a first stroke hospitalization. The risk of death was highest in the first few months and declined over time, but only about one-third of patients survived beyond 9 years 45. Similar trends were observed in Sweden, where 10-year survival after stroke improved from 13% to 35% over several decades .
Survival by Stroke Subtype
Survival rates differ by stroke subtype. In Japan, the 5-year survival rate after a non-fatal first-ever stroke was 65.9%, but this varied: lacunar infarction (75.1%), large-artery infarction (61.5%), cardioembolic infarction (44.9%), intracerebral hemorrhage (69.1%), and subarachnoid hemorrhage (77.9%) . In Germany, 5-year survival was highest for small-artery occlusion (about 72–76%) and lowest for cardioembolic stroke (36–48%) . Hemorrhagic strokes were consistently associated with higher mortality compared to ischemic strokes 45.
Impact of Age, Sex, and Comorbidities
Older age is strongly linked to lower survival rates after stroke, regardless of stroke type 345. Some studies found no significant difference in long-term survival between men and women after adjusting for age and stroke subtype , while others noted slightly lower survival in women . Pre-existing conditions such as heart failure, coronary disease, hypertension, and diabetes further reduce survival rates and increase the risk of recurrence 58.
Trends Over Time and Improvements in Survival
Long-term survival after stroke has improved over recent decades. A meta-analysis of international studies showed that 1-year case-mortality after stroke decreased from 42.9% in 1987 to 31.3% by 2013, and 5-year case-mortality dropped from 61.5% to 49.6% over the same period . These improvements are likely due to better prevention, acute care, and secondary prevention strategies 179.
Survival Rates by Stroke Type in the Acute Phase
Survival in the acute phase (first few weeks) is much lower for hemorrhagic strokes than for ischemic strokes. For example, 30-day case-fatality rates were 15% for brain infarction, 16% for cerebral embolus, 46% for subarachnoid hemorrhage, and 82% for intracerebral hemorrhage . At two years, survival rates were highest for lacunar infarcts and transient ischemic attacks, and lowest for hemorrhagic strokes .
Conclusion
Stroke survival rates have improved over time, but the risk of death remains high, especially in the first year and for certain stroke subtypes like hemorrhagic and cardioembolic strokes. Older age and comorbidities further reduce survival. Continued improvements in prevention, acute management, and long-term care are essential to further increase survival rates and reduce the burden of stroke worldwide 12345678+2 MORE.
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