Survival differences after stroke in a multiethnic population: follow-up study with the south London stroke register

Objectives To identify ethnic differences in survival after stroke and examine the factors that influence survival. Design Population based stroke register with follow-up. Settings South London stroke register. Participants 2321 patients with first stroke registered between January 1995 and December 2002. Main outcome measures Sociodemographic factors, risk factors for stroke and their management, severity of stroke, and acute service provision factors. Survival analysis with Kaplan-Meier curves, log rank test, and Cox's proportional hazard model with stratification. Results In univariable analyses of survival, outcome was better for black people than white people (median 33.7 v 20.0 months). After stratification by socioeconomic status, type of stroke, and Glasgow coma score, and adjustment for other potential confounders, being black was generally associated with better survival, taking into account the interaction between ethnicity and age, and ethnicity and prior Barthel score. Of the risk factors for stroke considered, current smoking (hazard ratio 1.21, 95% confidence interval 1.01 to 1.45, P = 0.044), untreated atrial fibrillation (1.36, 1.08 to 1.72, P = 0.009), untreated diabetes (1.53, 1.05 to 2.22, P = 0.027), and treated diabetes (1.61, 1.27 to 2.03, P < 0.001) were associated with reduced survival. Conclusion In general, black patients in a south London population with first ever stroke are more likely to survive than white patients, the exceptions being in those aged < 65 and those with a prior Barthel score < 15. Some pre-stroke risk factors that have the potential to be modified, including the appropriate treatment of existing health problems, have a strong impact on survival

Incidence of aetiological subtypes of stroke in a multi-ethnic population based study: the South London Stroke Register

International audienceSummary Background: Stroke risk is higher in black ethnic groups compared to white. Although risk factors for stroke are known to differ between these populations, few population studies have reported on the risk of aetiological stroke subtypes in Black ethnic populations. Methods: Ethnic group differences in incidence of first ever ischaemic stroke by aetiological subtype were investigated with the South London Stroke Register (SLSR). The SLSR is a population-based stroke register covering a multiethnic inner-city population of 271,871 inhabitants comprising 63% White, 28% Black and 9% other ethnic group. A modified pathophysiological Trial of Org 10172 (TOAST) classification of stroke was used to estimate patterns of aetiological subtype and stroke was subtyped into large artery atherosclerosis (LAA), cardioembolism (CE), small vessel occlusion (SVO), other aetiology (OTH), undetermined (UND) and multiple possible or concurrent aetiologies (CONC)