Published Papers - Abstract 729

Byles J, Francis L, Chojenta C & Hubbard I. Long-term survival of older Australian women with a history of stroke. Journal of Stroke and Cerebrovascular Disease, 2015; 24(1): 53-60

Background: While many people survive an initial stroke, little is known about long-term impacts of stroke on survival. Methods: Data from the Australian Longitudinal Study on Women’s Health (ALSWH) were used to compare 12-year survival rates in older women with prevalent stroke, incident stroke, and no stroke. Cox regression models were fitted to assess the effect of lifestyle and demographic characteristics on the relationship between stroke and all-cause mortality. The ‘no stroke’ group was used as the reference category in all statistical models.Results: At baseline, 4% of the women reported a previous stroke (prevalent stroke). At Survey 2 in 1999, a further 3% reported having a stroke between 1996 and 1999 (incident stroke). Stroke was significantly associated with reduced long-term survival. Age-adjusted Hazards Ratios (HR) were: HR:1.64 (1.43,1.89) for the ‘prevalent stroke’ group, and HR:2.29 (1.97,2.66) for the ‘incident stroke’ group. Adjusting for comorbidities reduced the hazard ratios, but the risk of death was still significantly higher in the two stroke groups. Adjusting for demographic and lifestyle factors did not make any further difference to the relationship between stroke and survival. However, obesity and past smoking were also risk factors for mortality. Conclusions: This study highlights the long-term impacts of stroke on life expectancy, and the importance of comorbidities and other lifestyle factors in affecting post-stroke survival.