Document Type : Original Article


1 1 Healthy Aging Research Centre, Neyshabur University of Medical Sciences, Neyshabur, Iran

2 Neurosciences Research Centre, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran


BACKGROUND AND OBJECTIVE: Data on the factors affecting long‑term mortality following a
stroke in Iran are scarce. The current research aimed at investigating the extent of 2‑year mortality
following a stroke and the factors affecting it in the northwest of Iran.
MATERIALS AND METHODS: This prospective cohort study was conducted in Tabriz, Northwest
of Iran. Patients with computed tomography/magnetic resonance imaging confirmed the first‑ever
stroke were included in this study and followed up to 2 years. Clinical examinations, including the
severity of the stroke using the modified National Institutes of Health Stroke Scale (mNIHSS), were
conducted by a neurologist. The general characteristics, lifestyle factors, and laboratory tests were
also completed. To estimate the survival, Kaplan–Meier analysis was used; and for group comparison,
the log‑rank method was applied. To identify the factors predicting 2‑year mortality, semiparametric
Cox regression analysis was used.
RESULTS: A total of 1036 first‑ever stroke patients were included in the present study. The
mortality rates of stroke in 6‑month, 1‑year, and 2‑years follow‑up periods were 31.6%, 34.5%, and
38%, respectively. The two‑year mortality rate was 33.6% in ischemic and 58.7% in hemorrhagic
stroke (P < 0.001). In the multivariate Cox model, variables age, type of stroke, diabetes, and severity
of the stroke, according to the mNIHSS index, were identified as factors predicting 2‑year mortality
following the stroke.
CONCLUSION: The 2‑year mortality following acute stroke was relatively high compared to that of in
developed countries. Implementation of secondary prevention is recommended to better management
of modifiable predictors of mortality.


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