Stroke - Outlook
Improvements in stroke treatment in many parts of the world have led to better outcomes, although outlook after a stoke may still be poor for some.
Poorer outcomes are associated with:
- Recurrent stroke
- Previous heart attackThe death of a section of heart muscle caused by an interruption in its blood supply. Also called a myocardial infarction. (myocardial infarctionDeath of an area of heart muscle due to poor blood supply.)
- Atrial fibrillation (an abnormal heart rhythm)
- High cholesterolA substance present in many tissues and an important constituent of cell membranes although high concentrations of a certain type of cholesterol in the blood are unhealthy. levels
Haemorrhagic strokes - that is, strokes caused by a bleed in or around the brain - are associated with the worst outcomes; meanwhile, 'mini-strokes' (transient ischaemic attacks, or TIAs) are associated with the best outcomes.
Healthcare professionals take a number of factors into account when assessing someone's likelihood of a full recovery after a stroke. These factors include the person's:[3,4]
- Initial symptoms
- Blood glucoseA simple sugar that is an important source of energy in the body. concentrations
- Body temperature (although it is not known whether a fever itself actually causes worse outcomes, or whether it is simply associated with other factors that lead to worse outcomes)
- Previous stroke history
Disability following a stroke is not only caused by physical impairment; depression, for example, can also contribute.
Additional medical problems that follow on from a condition such as stroke are called complications. There are many different possible complications from a stroke, and these can prolong a person's hospital stay and interfere with recovery. Such complications include:[7,8]
- Cheung CM, Tsoi TH, Hon SFK et al. Outcomes after first-ever stroke. Hong Kong Med J 2007; 13: 95-9
- 'Deaths from stroke.' WHO. Link. Last accessed 19 October 2009.
- Donnan GA, Fisher M, Macleod M et al. Stroke. Lancet 2008; 371: 1612-23.
- Patel MD, McKevitt C, Lawrence E et al. Clinical determinants of long-term quality of life after stroke. Age and Ageing 2007; 36: 316-22.
- Greer DM, Funk SE, Reaven NL et al. Impact of fever on outcome in patients with stroke and neurologic injury: a comprehensive meta-analysis. Stroke 2008; 39: 3029-35.
- Lo RSK, Cheng JOY, Wong EMC et al. Handicap and its determinants of change in stroke survivors: one-year follow-up study. Stroke 2008; 39: 148-53.
- Goldstein LB. Acute ischemic stroke treatment in 2007. Circulation 2007; 116: 1504-14.
- Khaja AM and Grotta JC. Established treatments for acuteHas a sudden onset. ischaemic stroke. Lancet 2007; 369: 319-30.
- Paracetamol could save hundreds after strokes
- Uric acid may lessen women’s disability after stroke
- Clot-removal devices now recommended for some stroke patients
- PTSD, traumatic experiences may raise heart attack, stroke risk in women
- The Joint Commission and the American Heart Association/American Stroke Association launch new stroke certification program
- Hospitals often overestimate their ability to deliver fast stroke care
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