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Serious hemorrhages after ischemic stroke or TIA – Incidence, mortality, and predictors

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  • Joachim Ögren
  • Anna-Lotta Irewall
  • Lars Söderström
  • Thomas Mooe

Abstract

Background: Data are lacking on the risk and impact of a serious hemorrhage on the prognosis after ischemic stroke (IS) or transient ischemic attack (TIA). We aimed to estimate the incidence of serious hemorrhage, analyze the impact on mortality, and identify predictors of hemorrhage after discharge from IS or TIA. Methods and findings: All patients admitted to Östersund Hospital for an IS or TIA in 2010–2013 were included (n = 1528, mean age: 75.1 years). Serious hemorrhages were identified until 31st December 2015. Incidence rates were calculated. The impact on mortality (stratified by functional level) was determined with Kaplan-Meier analysis. Non-parametric estimation under the assumption of competing risk was performed to assess the cumulative incidence and predictors of serious hemorrhages. Conclusions: We found that, after discharge from an IS or TIA, serious hemorrhages were fairly common. Impairments in function were associated with high mortality, but serious hemorrhages only increased the risk of mortality in patients with no or slight disability. Improved hypertension treatment may decrease the risk of serious hemorrhage, but in patients with low functional status, poor survival makes secondary prevention challenging.

Suggested Citation

  • Joachim Ögren & Anna-Lotta Irewall & Lars Söderström & Thomas Mooe, 2018. "Serious hemorrhages after ischemic stroke or TIA – Incidence, mortality, and predictors," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-13, April.
    • Handle: RePEc:plo:pone00:0195324
    DOI: 10.1371/journal.pone.0195324
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