Stroke recurrence and long-term mortality

The risk for recurrence in patients with either ischemic stroke (IS) or intracerebral hemorrhage (ICH) is substantial, especially with poor risk factor control. The impact of a first stroke versus a recurrent stroke on future events has not been well studied.

Some researchers used national health registries in Denmark to assess the 1-, 5-, and 10-year stroke recurrence rates, as well as 1- and 10-year mortality. Mortality was compared between a first stroke and a recurrent stroke.

Patient information was collected from May 2004 through 2018, totaling 105,397 IS cases (median age, 72) and 13,350 ICH cases (median age, 73), with a slight preponderance of men in both groups. IS recurrence rates were 4%, 10%, and 13%, and the ICH recurrence rates were 3%, 8%, and 12%. Mortality rates were higher after recurrent IS events (25% at 1 year; 70% at 10 years) than after a first ischemic stroke. For IS patients, recurrence rates were higher with advanced age up to age 79, male sex, and a milder index stroke.

These data are valuable since they represent information from a country with universal health insurance and a national registry. The data reinforce the substantial risks for recurrence and mortality after either IS or ICH. This study provides an important reminder about the need for multifaceted stroke prevention measures (including medication and lifestyle change) to reduce recurrence and mortality rates.