Midway Evaluation - Sara Maria Mathisen

The Candidate is affiliated to the Department of Clinical Medicine. Principle Supervisor - Martin Kurz.

Stavanger Stroke Study – long-term mortality of stroke patients with focus on statin treated carotid stenosis, modifiable risk factors and nursing home placement in south-west Norway

Principal supervisor: Martin Kurz, MD PhD, Co-supervisor: Jan Petter Larsen, professor MD

Background: Stroke is one of the leading causes of mortality in the world and one of the most devastating of all neurological conditions. About six million people die each year of a stroke and 15.000 Norwegians suffer a stroke each year. The risk of death from stroke is highest in the first few weeks after the stroke, and short term mortality is intensely studied. Due to the many advances that have been made in terms of prevention and mortality in cardiovascular diseases, the mortality from stroke has declined steadily and more patients survive their strokes. Knowledge of long-term mortality and its clinical predictors offers the opportunity to better control the risk factors in the follow-up after a stroke. Therewith it offers the possibility to abate stroke mortality even further.

Paper 1, Treatment with statins improves long-term survival in individuals with carotid artery stenosis. Wörlund SM, Kurz MW, Hegland O, Brønnick K, Munk PS, Larsen JP. Int J Cardiol. 2013 Sep 20;168(1):624-6

We have investigated survival and causes of death in a long-term follow-up in 230 patients with at least 40% ICA-stenosis with and without statin treatment first studied in 2001. The mean follow-up time was 12.8 years. The results indicate that use of statins seems to increase long-term survival in patients with established carotid artery stenosis significantly. There were no differences in cause of death.

Paper 2, Mathisen SM, Dalen I, Larsen JP, Kurz MW. “Long-term mortality and its risk factors in stroke survivors” is recommended for publication in the international, peer-rewived journal “Cerebrovascular Diseases” by 10.3.2015. The revised version is submitted and awaiting the result of the peer-review process.

We examined the long-term mortality in 1137 patients with acute stroke and compared it to a geographically, age and sex-matched, stroke-free control group. We followed the stroke patients for up to 16.4 years, and identified risk factors present at index stroke that might predict long-term mortality. The results indicate that stroke patients surviving the first year after stroke have a markedly increased mortality rate during long-term follow-up. Further, the results from this study indicate that changes in creatinine, homocysteine and glucose could be addressed more aggressively as a standard routine after acute stroke.

Paper 3, Mathisen SM, Vossius C, Larsen JP, Kurz M. We examine the incidence and length of permanent nursing home placement for stroke patients in the community of Stavanger. We also identify risk factors at index stroke for the 452 patients compared to a matched, stroke-free control group from the general population. The costs for society in a population surviving a stroke will be compared to a stroke free control cohort.

 Venue:- Stavanger.