AI Insight
This study analyzed 1,344 stroke patients treated between 2017-2020 and followed for a median of 5.2 years to determine long-term causes of death. While cerebrovascular disease caused most deaths during initial hospitalization (36.0%), it accounted for only 15.5% of deaths after discharge. Among ischemic stroke survivors, cardiac disease became the leading cause of death (31.6%), including sudden cardiac arrest (10.9%), while cancer predominated among hemorrhagic stroke survivors (38.9%).
Why it matters
The findings suggest that stroke survivors need different follow-up care depending on stroke type, particularly heightened cardiac monitoring and sudden death risk assessment for ischemic stroke patients. This could inform development of subtype-specific post-stroke surveillance protocols to address the actual long-term mortality risks rather than focusing primarily on recurrent stroke prevention.
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⚠️ Preprint – Noch nicht peer-reviewed
Dieser Artikel wurde noch nicht von unabhängigen Experten begutachtet. Die Ergebnisse sind vorläufig und sollten mit Vorsicht interpretiert werden.
Background: Contemporary data on long-term, cause-specific mortality among stroke survivors are sparse, and much of the existing evidence derives from studies performed before the modern reperfusion era. We sought to characterize long-term cause-specific mortality among stroke survivors to discharge (differentiated by stroke subtype) when compared to in-hospital stroke decedents treated under contemporary standards of care. Methods: Using a hybrid billing-code/imaging and large language model-assisted chart-review pipeline, we identified adults hospitalized for ischemic or hemorrhagic stroke in the Observational Study of Cardiac Arrest Risk (OSCAR) cohort (Cedars-Sinai Health System, Los Angeles) between 2017 and 2020, followed through June 30, 2025. Cause of death was determined and classified into 10 categories. Results: Among 1,344 stroke patients (mean age 74.0 {+/-} 14.9 years; ischemic n=1,036 [77.1%], hemorrhagic n=308 [22.9%]), 203 (15.1%) did not survive the index stroke. Of the 1,141 discharged survivors, 625 (54.8%) died over a median follow-up of 5.2 years. Cerebrovascular causes predominated during index stroke hospitalization (36.0%) but accounted for only 15.5% of post-stroke discharge deaths. Among ischemic stroke survivors, cardiac disease was the leading cause of death (31.6%), with sudden cardiac arrest alone accounting for 10.9% of deaths. Among hemorrhagic stroke survivors, cancer (38.9%) was the leading cause of death. Despite these divergent cause-of-death profiles, overall survival did not differ significantly by subtype (median 5.5 vs 5.8 years; P=0.90). Conclusions: In this contemporary, reperfusion-era cohort, causes of death shifted from cerebrovascular predominance in the acute phase to heart disease/cardiac arrest after ischemic stroke, and malignancy after hemorrhagic stroke. These findings argue for development of subtype-specific post-stroke surveillance, including structured longitudinal cardiac and sudden-death risk assessment for ischemic stroke survivors.