No abstract

The purpose of this study was to report five-year survival and recurrence rate after first-time stroke using the data obtained by multicenter prospective cohort study in Korea. This study was an interim analysis of the Korean Stroke Cohort for Functioning and Rehabilitation (KOSCO). Data of 10,636 first-time stroke patients (8,210 ischemic and 2,426 hemorrhagic) who were admitted to the 9 district hospitals of Korea were analyzed. In order to compensate the missing values due to the follow-up failure, KOSCO data were linked with the National Health Insurance Service data until 2020. Mortality and recurrence rate up to five years were estimated by Kaplan-Meier estimation and the Cox regression analysis. The oneyear cumulative mortality rate was 11.8%, the three-year 18.9%, and the five-year 25.2%. Ischemic stroke, male, older age, combined diseases, hypertension, in-hospital pneumonia, lack of intensive rehabilitation, moderate to severe initial stroke severity (National Institutes of Health Stroke Scale >15), low initial motor function (Fugl-Meyer Assessment <85), and low ambulatory functions (Functional Ambulatory Category 0-3) showed higher hazard ratio for mortality (p<0.05). The one-year cummulative recurrence rate was 8.9%, the three-year 12.7%, and the five-year 15.5%. According to Cox regression analysis, stroke type (ischemic) and initial stroke severity were significant factors for stroke recurrence (p<0.05). Of the factors affecting 5-year mortality after first-time stroke, two modifiable factors were defined as pneumonia and intensive rehabilitation during the first admission period.