Objective: To describe the survival status and to analyze the factors associated with mortality on first-ever stroke patients.
Methods: The first-ever stroke patients registered in 2009 were collected from "Zhejiang provincial information system for NCDs' surveillance and management". Survival status and the cause of death through active and passive follow-up programs, were collected. Kaplan-Meier methods were used for survival description. Monovariant and multivariant Cox's proportional hazard regression models were used to analyze risk factors on mortality.
Results: A total of 78 189 patients, who suffered from cerebral infarctions (ICD-10:I63), intracerebral haemorrhages(I61), subarachnoid haemorrhages (I60) and unspecified strokes (I64), accounted for 61.65%, 30.42%, 2.32% and 5.62%, were recruited. 33 265 cases died during the period of this study. 27 147 cases were stroke related, accounted for 81.61%. 6 122 cases died on the same day, with one-day case fatality as 7.83% and the overall 28-day case fatality as 21.01%. The survival rates from one-year to four-year were 72.04% , 68.92%, 66.27% and 64.29%, respectively. The four-year survival rates of I63, I61, I60 and I64 were 80.06%, 50.15%, 71.80% and 21.41%, respectively. Effect of the model showed that the risk factors associated with mortality were age, gender, educational level, the diagnosis and quality of the hospitals on treatment, hypertension and the types of stroke incidences. Age had interacted with gender (P < 0.001). Results from the 'single effect' showed that males had higher risk than females in those younger than 75 years old, but vice versa in those older than 75 of age.
Conclusion: Patients appeared very high risk of death in both acute and sub-acute phases. Factors including age, gender, educational level, both quality on diagnosis and treatment of the hospitals, clinical types of hypertension and stroke etc. were at risk, associated with prognosis of the disease.