Mortality and causes of death after first ischemic stroke: the Northern Manhattan Stroke Study

Neurology. 2001 Dec 11;57(11):2000-5. doi: 10.1212/wnl.57.11.2000.

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 (< or =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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • African Continental Ancestry Group
  • Aged
  • Aged, 80 and over
  • Cause of Death*
  • Cerebral Infarction / ethnology
  • Cerebral Infarction / mortality*
  • Cross-Sectional Studies
  • European Continental Ancestry Group
  • Female
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • New York City / epidemiology
  • Prospective Studies
  • Survival Analysis
  • Urban Population / statistics & numerical data*