脑血管事件后的死亡率和长期残疾：阿根廷布宜诺斯艾利斯维勒加斯市的一项前瞻性队列研究。

IF 1.8 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-08-16 DOI:10.1016/j.jstrokecerebrovasdis.2025.108426

Matías J Alet , Mario O Melcon , Sebastián F Ameriso

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引用次数: 0

摘要

背景：中风是世界范围内死亡和残疾的一个主要原因，在低收入和中等收入国家造成了不成比例的负担。然而，拉丁美洲缺乏长期的、基于人群的结果数据。我们的目的是估计阿根廷社区队列脑血管事件后的死亡率和致残率。方法：我们在布宜诺斯艾利斯的General Villegas进行了一项前瞻性、基于人群的队列研究，包括2017年6月1日至2020年5月31日期间发生的所有脑血管事件（缺血性卒中、出血性卒中、蛛网膜下腔出血和短暂性缺血性发作）。研究人员对患者进行了长达5年的随访，每年对患者的死亡率和致残率进行评估。对死亡率进行了计算，并对国家和世卫组织人口进行了年龄标准化。探索性Cox回归确定了死亡率的基线预测因子。结果：5年累计死亡率为50.5%，其中38%发生在第一年。粗死亡率为每10万人年131.3人，按阿根廷人口标准计算为每10万人109.4人。老年和较高的基线残疾与死亡率增加独立相关。在幸存者中，70.5% （n=72）的患者在一年时功能预后良好（mRS≤2），而70.6% （n=24）的患者在五年时功能预后良好。排除短暂性脑缺血发作（n=19）的敏感性分析得出了类似的死亡率估计。结论：阿根廷人群脑血管事件后的长期死亡率很高，这突出了卒中护理和随访方面的差距。尽管如此，随着时间的推移，大多数幸存者保持了功能上的独立。这些发现强调了综合卒中系统和长期监测策略的必要性，特别是在服务不足的环境中。

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Mortality rates and long-term disability after cerebrovascular events: A prospective cohort study in general Villegas, Buenos Aires, Argentina. The EstEPA population study

Background

Stroke is a major cause of death and disability worldwide, with a disproportionate burden in low- and middle-income countries. However, long-term, population-based outcome data are scarce in Latin America. We aimed to estimate mortality and disability after cerebrovascular events in a community-based cohort from Argentina.

Methods

We conducted a prospective, population-based cohort study in General Villegas, Buenos Aires, including all incident cerebrovascular events (ischemic stroke, hemorrhagic stroke, subarachnoid hemorrhage, and transient ischemic attack) from June 1, 2017 to May 31, 2020. Patients were followed for up to five years, with annual assessment of mortality and disability. Mortality rates were calculated and age-standardized to national and WHO populations. Exploratory Cox regression identified baseline predictors of mortality.

Results

The five-year cumulative mortality was 50.5 %, with 38 % of deaths occurring within the first year. The crude mortality rate was 131.3 per 100,000 person-years, and 109.4 per 100,000 when standardized to the Argentine population. Older age and higher baseline disability were independently associated with increased mortality. Among survivors, 70.5 % (n = 72) had good functional outcomes (mRS ≤2) at one year, and 70.6 % (n = 24) at five years. A sensitivity analysis excluding transient ischemic attacks (n = 19) yielded similar mortality estimates.

Conclusions

Long-term mortality after cerebrovascular events in this Argentine population was high, highlighting gaps in stroke care and follow-up. Nonetheless, most survivors maintained functional independence over time. These findings underscore the need for integrated stroke systems and long-term monitoring strategies, especially in underserved settings.

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.