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Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year
Appelros P, Nydevik I, Viitanen M.. Stroke, 2003-01-01
Topic: Risk, prevention and care in population studies
Background and purpose The purpose of this study was to define predictors of poor outcome after a first-ever stroke. We studied risk factors and stroke severity at baseline in relationship to death, dependency, and stroke recurrence within a year after the event. Methods The study included a community-based cohort of first-ever stroke patients. Subarachnoid hemorrhage was not included. All patients (n=377) were subjected to investigations regarding risk factors. Stroke severity was evaluated with the National Institutes of Health Stroke Scale, and dependency was defined according to the modified Rankin Scale. Multivariate regression models were used to analyze predictors of survival, dependency, and stroke recurrence. The following independent variables were used: age, sex, cohabitation status, cigarette smoking, dementia, hypertension, ischemic heart disease, heart failure, atrial fibrillation, diabetes mellitus, transitory ischemic attack, peripheral atherosclerosis, and stroke severity. Results The 1-year mortality was 33%. After 1 year, 37% of the survivors were dependent; 9% of survivors had a recurrent stroke within a year. Dementia, age, stroke severity, and atrial fibrillation were associated with death within a year. Dependency was associated with age, stroke severity, and heart failure. Stroke recurrence was predicted by age and dementia. Conclusions In addition to age and stroke severity, heart diseases and dementia before the stroke seem to have an impact on mortality and recurrence after 1 year. Finding and, when possible, treating these prestroke conditions may affect stroke morbidity and mortality favorably.
Key findings
- Dementia, age, stroke severity, and atrial fibrillation were associated with death within a year.
- Dependency was associated with age, stroke severity, and heart failure.
Why it matters
Among people after a first-ever stroke, dementia, age, stroke severity and atrial fibrillation were associated with death within a year, and dementia predicted stroke recurrence. This describes outcomes after stroke and does not test any treatment for Alzheimer's disease.
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Study details
- Participants377
- Evidence strengthModerate
How this study scored 52/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 2 / 4 | 377 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 440 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 17.6 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 4 / 6 | Cited 11.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 1 other studies in this library |
| Still being cited | 2 / 4 | Cited 37 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Matti H. Viitanen: h-index 81 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Karolinska Institutet: institution h-index 1,477 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12511762) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 52 / 100 | — |
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APA 7th
Appelros, P., Nydevik, I., & Viitanen, M. (2003). Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year. Stroke. https://doi.org/10.1161/01.str.0000047852.05842.3c
Vancouver
Appelros P, Nydevik I, Viitanen M. Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year. Stroke. 2003. doi:10.1161/01.str.0000047852.05842.3c. PMID: 12511762.
BibTeX
@article{appelros2003-12511762,
author = {Appelros, P. and Nydevik, I. and Viitanen, M.},
title = {{Poor outcome after first-ever stroke: predictors for death, dependency, and recurrent stroke within the first year}},
journal = {Stroke},
year = {2003},
doi = {10.1161/01.str.0000047852.05842.3c},
pmid = {12511762},
url = {https://doi.org/10.1161/01.str.0000047852.05842.3c}
}
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