Long Term Postischemic Stroke Mortality in Diabetes
- 1 October 2008
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Stroke
- Vol. 39 (10), 2727-2731
- https://doi.org/10.1161/strokeaha.108.517441
Abstract
Background and Purpose— Recent data on stroke mortality in diabetics in the United States is lacking. We investigated trends in diabetes prevalence and stroke morality among diabetics in a large veteran cohort. Methods— The Patient Treatment File was used to identify all patients discharged from any Veterans hospital between October 1990 and September 1997 with a diagnosis of ischemic stroke (ICD-9-CM codes 434, 436) listed as primary diagnosis. Demographic, morbidity, and mortality data were recorded. Chi-square tests were used to examine differences between diabetics and nondiabetics, and t tests were used for continuous variables. Cox proportional hazards regression was used to examine the effects of diabetes (DM) on the survival times controlling for multiple covariates. Results— Of 48 733 ischemic stroke patients identified, 98% were male and 13 925 (25%) had DM. Mean age was similar between DM and non-DM (67.2 versus 67.5, P =NS). Prevalence of DM among stroke subjects increased from 25% to 31%. Charlson index >2 was much higher in DM (68.2% versus 47.9%, P P =NS; 12.6 versus 13.1, P =NS). Kaplan-Meier survival plot showed that DM had shorter long term survival time (log-rank, P P Conclusion— Despite greater comorbidity, postacute ischemic stroke mortality at 60 days and 1 year is not different between subjects with and without DM. Long term mortality after stroke is much lower among DM than that reported in older studies.Keywords
This publication has 21 references indexed in Scilit:
- Sulfonylureas Improve Outcome in Patients With Type 2 Diabetes and Acute Ischemic StrokeStroke, 2007
- Stroke Mortality and Race: Does Access to Care Influence Outcomes?The American Journal of the Medical Sciences, 2007
- Declining stroke burden among white and black male veteran subjectsJournal of the American Society of Hypertension, 2007
- Impact of Female Gender on Prognosis in Type 2 Diabetic Patients with Ischemic StrokeEuropean Neurology, 2006
- Coding of Stroke and Stroke Risk Factors Using International Classification of Diseases , Revisions 9 and 10Stroke, 2005
- Diabetes and Cardiovascular Disease Executive Summary Conference Proceeding for Healthcare Professionals From a Special Writing Group of the American Heart AssociationCirculation, 2002
- Geographic Variations in Utilization Rates in Veterans Affairs Hospitals and ClinicsNew England Journal of Medicine, 1999
- Inaccuracy of the International Classification of Diseases (ICD-9-CM) in identifying the diagnosis of ischemic cerebrovascular diseaseNeurology, 1997
- Adapting a clinical comorbidity index for use with ICD-9-CM administrative databasesJournal of Clinical Epidemiology, 1992
- Studying Outcomes and Hospital Utilization in the ElderlyMedical Care, 1992