| Research Abstract |
A total of 4,756 strokes cases (4,511 patients and 1,059 acute myocardial infarction (AMI) cases 1992 patients) were registered between April 1, 1988 and March 31, 1991 in Okinawa (1990 census population: 1.22 million).
Follow-up survey was done at March 1, 1999. Their survival was confirmed using the death certificate and/or resident card.
The subjects followed were 4,363 patients (96.7%) in stroke patients and 958 patients (96.6%) in AMI. Among stroke patients, 2,218 patients with brain infarction (BI) and 1,589 patients with brain hemorrhage (BH) were analyzed for prognosis.
The mean age at onset was 70 years (men 68 and women 73) in patients with BI, 64 years (men 61 and women 67) in patients with BH and 67 years (men 63, women 75) in patients with AMI. The cumulative survival rate at 10-years was 39% (men 39 and women 38) in patients with BI, 43% (men 44 and women 42) in patients with BH and 41% (men 48, women 27) in patients with AMI. Fifty percent survival was 7.8 years (men 7.9 an
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d women 7.3) in patients with BI, 8.1 years with BH (men 8.7 and women 7.3) in patients with BH, and 7.5 years (men 9.8, women 3.8) in patients with AMI.
COX proportional hazard model was applied for analysis.
Significant predictors of death in patients with BI were age at onset (Risk Ratio 1.07, 95% confidence interval 1.06-1.08), men (vs women 1.25, 1.05-1.48), recurrence (vs first-ever 1.63, 1.35-1.98), atrial fibrillation (1.56, 1.26-1.93), any consciousness disturbance at onset (1.50, 1.25-1 .79), and cortical infarction (vs lacuna 1.31, 1.09-1.56). That in patients with BH were age (1.05, 1.04-1.06), men (1.33, 1.09-1.60), recurrence (vs firtst-ever 1.43, 1.13-1.81), any consciousness disturbance (1.83, 1.50-2.23), and size of lesion lager than 6cm in diameter (3.03, 2.39-3.83). And that in patients with AMI were age at onset (Risk Ratio 1.06, 95% confidence interval 1.05-1.08), men (1.11, 0.86-1.43), history of hypertension (1.68, 1.32-2.14), Q wave infarction (vs non-Q 0.60, 0.48-0.77), and Killip class (every one class up 1.51, 1.36-1.66).
Age-adjusted incidence rate (per 1000000 per year) of stroke and AMI between Apr 1, 1988 and Mar 31, 1991 were 141 (men 187, women 108), 32 (men 52, women 16). And that of 1999 was now on case confirming process. Less
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