Mortality and causes of death after first ischemic stroke: The Northern Manhattan stroke study

Andreas Hartmann, T. Rundek, H. Mast, M. C. Paik, B. Boden-Albala, J. P. Mohr, R. L. Sacco

Research output: Contribution to journalArticle

Abstract

Objective: To analyze the early and long-term causes of death after first ischemic stroke in the multiethnic northern Manhattan community. Methods: In the prospective, population-based Northern Manhattan Stroke Study, 980 patients with first ischemic stroke (mean age 70 years; 56% women; 49% Caribbean Hispanic, 31% black, 20% white) were followed for a mean of 3 years. Causes of death were classified as vascular (incident stroke, recurrent stroke, cardiac) or nonvascular. Life table analyses were used to assess mortality risks among different race-ethnic groups. Early (≤1 month) vs long-term (>1 month to 5 years) causes of death were compared. Results: Among the 980 patients followed, 278 (28%) died; 47 (5%) died during the first month. Cumulative mortality risk was 5% at 1 month, 16% after 1 year, 29% after 3 years, and 41% after 5 years. The proportion of vascular deaths among all deaths was 75% at 1 month and 43% thereafter (p = 0.001). Stroke, either incident (53%) or recurrent (4%), caused early deaths in 57% and long-term deaths in 14% (p = 0.001). Overall mortality risks did not differ significantly among race-ethnic groups. However, the proportion of incident stroke-related early deaths was 85% in Caribbean Hispanic patients, 33% in white patients, and 25% in black patients (p = 0.002). Conclusions: Among patients with first ischemic stroke, incident stroke is the leading cause of early deaths. A large proportion of long-term deaths are nonvascular in origin. Despite similar overall mortality rates in race-ethnic groups, our data suggest a higher incident stroke-related early mortality among Caribbean Hispanics.

Original languageEnglish (US)
Pages (from-to)2000-2005
Number of pages6
JournalNeurology
Volume57
Issue number11
DOIs
StatePublished - Dec 11 2001

ASJC Scopus subject areas

  • Clinical Neurology

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    Hartmann, A., Rundek, T., Mast, H., Paik, M. C., Boden-Albala, B., Mohr, J. P., & Sacco, R. L. (2001). Mortality and causes of death after first ischemic stroke: The Northern Manhattan stroke study. Neurology, 57(11), 2000-2005. https://doi.org/10.1212/WNL.57.11.2000