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Differences in cardiovascular risk factors and socioeconomic status do not explain the increased risk of death after a first stroke in diabetic patients: results from the Swedish Stroke Register
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Department of Applied Mathematics, Computer Science and Statistics, Ghent University, Ghent, Belgium.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
2013 (English)In: Diabetologia, ISSN 0012-186X, E-ISSN 1432-0428, Vol. 56, no 10, 2181-2186 p.Article in journal (Refereed) Published
Abstract [en]

AIMS/HYPOTHESIS: This study compared survival rates and causes of death after stroke in diabetic and non-diabetic patients in Sweden. We hypothesised that differences in cardiovascular risk factors, acute stroke management or socioeconomic status (SES) could explain the higher risk of death after stroke in diabetic patients. METHODS: The study included 155,806 first-ever stroke patients from the Swedish Stroke Register between 2001 and 2009. Individual patient information on SES was retrieved from Statistics Sweden. Survival was followed until 2010 (532,140 person-years) with a median follow-up time of 35 months. Multiple Cox regression was used to analyse survival adjusting for differences in background characteristics, in-hospital treatment, SES and year of stroke. Causes of death were analysed using cause-specific proportional hazard models. RESULTS: The risk of death after stroke increased in diabetic patients (HR 1.28, 95% CI 1.25, 1.31), and this risk was greater in younger patients and in women. Differences in background characteristics, cardiovascular risk factors, in-hospital treatment and SES did not explain the increased risk of death after stroke (HR 1.35, 95% CI 1.32, 1.37) after adjustments. Diabetic patients had an increased probability of dying from cerebrovascular disease and even higher probabilities of dying from other circulatory causes and all other causes except cancer. CONCLUSIONS/INTERPRETATION: Differences in cardiovascular risk factors, acute stroke management and SES do not explain the lower survival after stroke in diabetic compared with non-diabetic patients. Diabetic patients are at higher risk of dying from cardiovascular causes and all other causes of death, other than cancer.

Place, publisher, year, edition, pages
2013. Vol. 56, no 10, 2181-2186 p.
Keyword [en]
Case fatality, Diabetes, Register, Socioeconomic status, Stroke, Survival
National Category
Cardiac and Cardiovascular Systems Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:umu:diva-76710DOI: 10.1007/s00125-013-2983-0ISI: 000324062800011PubMedID: 23820634Scopus ID: 2-s2.0-84890128708OAI: oai:DiVA.org:umu-76710DiVA: diva2:636717
Available from: 2013-07-11 Created: 2013-07-11 Last updated: 2017-12-06Bibliographically approved

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