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Four patients(2%)with major strokes died acutely.Information 9on stroke recurrence and disability was available for 184(87%)of the survivors and on retirement and working status for 140(67%)of the patients.Two patients died from cancer.Seven transient ischemic attacks and eight strokes(two hemorrhagic)occurred during follow-up.Patients with strokes of unknown cause experienced no recurrent strokes,contrasting with two deaths and eight strokes in those whose stroke cause was identified(difference between proportions:8%;95%confidence interval,3-13).Eighty-eight patients had a complete recovery,and only 21 were disabled(Rankin grades 4 or 5). Logistic regression analysis identified the severity of the initial stroke (Rankin grade>3)as the only significant predictor of disability(odds ratio,10.7;95%confidence interval,3.7 to 30.6).Of the survivors,73%were working and only 18%were retired.Disability at follow-up was the best(but nonsignificant)predictor of retirement(odds ratio,1.6:95%confidence interval,0.8 to 3.4).Ischemic stroke in young adults has a low acute mortality and few recurrences,more so if the cause is not identified.The majority of patients return to an active professional life.Severity of the initial stroke is the major predictor of independence.The relation between disability and return to work or retirement is less clear. |
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