Case-Fatality, Disability and Recurrence Rates After First-ever Stroke: a study from Bigdata Observatory Platform for Stroke of China.

BACKGROUND: There is currently a lack of data on stroke hospitalizations and long-term outcomes in China. Therefore, we investigated 12-month stroke fatality, disability, and recurrence rates after the first-ever stroke METHODS: This was a prospective nationwide hospital-based cohort study. From August to September 2019, all patients with first-ever stroke (ischemic stroke [IS], intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) and with symptom onset within 14 days from 232 hospitals were included. Case fatality, disability, and recurrence rates for one year were estimated.

RESULTS: In total, 36250 first-ever stroke patients from 194 hospitals were recruited (median age was 65(IQR, 56-73) years and 61.4% were male). The rate of intravenous thrombolysis and endovascular treatment for IS were 9.5% and 4.4%, respectively. In-hospital death rate was 1.9% (95%CI: 1.7%-2.0%) for stroke inpatients, ranging from 0.9% (0.8%-1.1%) for IS to 5.1% (4.6%-5.6%) for ICH. The 12-month fatality rate was 8.6% (95%CI: 8.3%-8.9%) for discharged stroke patients, ranging from 6.0% (5.7%-6.3%) for IS to 17.7% (16.7%-18.7%) for ICH. The 12-month disability rate was 16.6% (95%CI: 16.2%-17.0%) for stroke survivors, ranging from 11.1% (9.3%-12.8%) for SAH to 29.2% (27.9%-30.4%) for ICH. The stroke recurrence rate was 5.7% (5.5%-6.0%) for stroke survivors, ranging from 2.5% (1.7%-3.3%) for SAH to 6.4% (6.0%-6.7%) for IS.

CONCLUSION: Our results support the hypothesis that the prognosis of Chinese stroke patients appears to have improved and is not very bad.