Long-term survival of patients with cerebrovascular accident in different age groups in the REGION-M registry

Aim. To study the two-year survival rate of patients with cerebrovascular accident (CVA) in different age groups.

Material and methods. The outpatient part of the REGION-M registry included 684 patients assigned to the City Polyclinic № 64 in Moscow, discharged from the F. I. Inozemtsev City Clinical Hospital (Moscow) in the period from January 1, 2012 to April 30, 2017 with a confirmed diagnosis of stroke or transient ischemic attack. All patients were divided into 5 age groups: group 1 — from 18 to 50 years old (n=72 (10,5%)), group 2 — from 51 to 60 years old (n=122 (17,8%)), group 3 — from 61 to 70 years old (n=156 (22,8%)), group 4 — from 71 to 80 years old (n=185 (27,0%)) and group 5 — 81 years and above (n=149 (21,8%)). Patient survival was assessed after 2 years of follow-up.

Results. The mortality rate of patients during the follow-up period significantly increased with age as follows: in patients of 18-50 years old — 4%, 51-60 years old — 9,8%, 61-70 years old — 23,7%, 71-80 years old — 34%, 81-100 years old — 55% (p<0,0001). The relative death risk was 2,3 in group 2 (NA), 6,8 in group 3 (p<0,001), 9,8 in group 4 (p<0,0001) and 18,5 in group 5 (p<0,0001) compared with group 1. With increasing age in the study cohort, the proportion of women increased as follows: from 47,2% in group 1 to 77,9% in group 5 (p<0,0001). However, mortality among men and women in the groups did not differ. Patients in older age groups were more likely to have comorbidities and disability before the CVA. With increasing age, ischemic stroke was significantly more common and transient ischemic attack was less common (p<0,001).

Conclusion. Mortality of patients who underwent stroke was significantly higher in older age groups and did not differ among men and women.

1. Drapkina OM, Kontsevaya AV, Kalinina AM, et al. 2022 Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines. Cardiovascular Therapy and Prevention. 2022;21(4):3235. (In Russ.) doi:10.15829/1728-8800-2022-3235.

2. Benjamin EJ, Muntner P, Alonso A, et al. Heart Disease and Stroke Statistics — 2019 Update: A Report From the American Heart Association. Circulation. 2019;139(10):56-528. doi:10.1161/CIR.0000000000000659.

3. Martsevich SYu, Kutishenko NP, Suvorov AYu, et al., on behalf of the working group study "LIS-2". The study of anamnestic factors and their role in estimation of short-term (in-hospital) prognosis in patient underwent brain stroke or transient ischemic attack, by the data LIS-2 registry. Russian Journal of Cardiology. 2015;(6):14-9. (In Russ.) doi:10.15829/1560-4071-2015-6-14-19.

4. Bejot Y, Bailly H, Graber M, et al. Impact of the Ageing Population on the Burden of Stroke: The Dijon Stroke Registry. Neuroepidemiology. 2019; 52(1-2):78-85. doi:10.1159/000492820.

5. Romain G, Mariet АS, Jooste VG, et al. Long-Term Relative Survival after Stroke: The Dijon Stroke Registry c Neuroepidemiology. 2020;54:498-505. doi:10.1159/000505160.

6. Zagrebelny AV, Lukina YuV, Kutishenko NP, et al., on behalf of the REGION-M workgroup. Factors associated with in-hospital mortality in patients after acute cerebrovascular accident (according to the REGION-M register). Cardiovascular Therapy and Preven­tion. 2020;19(1):2443. (In Russ.) doi:10.15829/1728-8800-2020-1-2443.

7. Tolpygina SN, Martsevich SYu, Deev AD. The influence of concomitant diseases on a long-term prognosis in patients with chronic ischemic heart disease according to the PROGNOZ IBS register. Rational Pharmacotherapy in Cardiology. 2015;11(6):571-6. (In Russ.) doi:10.20996/1819-6446-2015-11-6-571-576.

8. Arauz A, Marquez-Romero JM, Barboza MA, et al. Mexican-National Institute of Neurology and Neurosurgery-Stroke Registry: Results of a 25-Year Hospital-Based Study. Front Neurol. 2018;9:1-8. doi:10.3389/fneur.2018.00207.

9. Martsevich SYu, Tolpygina SN, Chernysheva MI, et al. Adherence to attendance at outpatient clinic and longterm survival of patients after stroke in outpatient setting: the data of REGIOM-M registry. Rational Pharmacotherapy in Cardiology. 2021;3(17):386-93. (In Russ.) doi:10.20996/1819-6446-2021-06-04.

10. Martsevich SYu, Semenova YuV, Kutishenko NP, et al. Assessment of patients compliance for ambulatory institution visits and its influence on the quality of treatment before development of acute coronary syndrome, by the LIS-3 registry. Russian Journal of Cardiology. 2016; (6):55-60. (In Russ.) doi:10.15829/1560-4071-2016-6-55-60.

11. Parfenov VА, Verbitskaya SV. Secondary prevention of ischemic stroke: international recommendations and clinical practice. Neurology J. 2014;2:4-10. (In Russ.) doi:10.18821/1560-9545-2014-19-2-4-10.

12. Boytsov SA, Martsevich SYu, Ginzburg ML, et al. Lyubertsy study on mortality rate in patients after cerebral stroke or transient ischemic attack (LIS-2). Design and medical treatment estimation. Rational Pharmacotherapy in Cardiology. 2013;9(2):114-22. (In Russ.) doi:10.20996/1819-6446-2013-9-2-114-122.

13. Martsevich SYu, Tolpygina SN, Zagrebelny AV, et al. Quality of medication therapy in patients after stroke depending on presence/absence of diabetes: data from the out­patient stage of REGION-M registry. Cardiovascular Therapy and Prevention. 2021;20(5):2856. (In Russ.) doi:10.15829/1728-8800-2021-2856.