Prognosis

The risk of dying following an ischaemic stroke is increased with:

• increasing age ^{a b}
• a severe ^a or worsening stroke ^b
• atrial fibrillation ^{a b}
• ischaemic heart disease (particularly if an early onset)  ^b or intermittent claudication ^b
• smoking ^a
• heart failure ^b
• an elevated glucose on admission ^a
• an elevated CRP (> 33 mg/dl) on admission ^a
• urinary incontinence ^b
• unpartnered marital status ^b

Stroke risk factors and increasing age increase the risk of dying

Patient	Prognostic Factor	Outcome	CER	OR (95% CI)	NNF+ (95% CI)
ischaemic stroke a	smoking  independent	death at 30 days	30%	1.87 (1.07 to 3.27)	7 (4 to 70)
	atrial fibrillation  independent		21%	1.84 (1.04 to 3.27)	9 (4 to 154)
	increasing age (per 10 years)   independent			1.66 (1.27 to 2.17)
first ischaemic stroke a	ischaemic heart disease by age 50  independent	death at 5 years	69%	3.14 (2.05 to 4.81)	5 (4 to 8)
	ischaemic heart disease by age 60  independent			2.26 (1.68 to 3.04)	7 (6 to 10)
	ischaemic heart disease by age 70  independent			1.63 (1.35 to 1.97)	11 (8 to 17)

A severe stroke, heart failure or urinary incontinence increase the risk of dying

Patient	Prognostic Factor	Outcome	CER	RR (95% CI)	NNF+ (95% CI)
ischaemic stroke a	major hemispheric or basilar syndrome  independent	death at 5 years	44%	2.00 (1.30 to 3.00)	2 (1 to 8)
	admission glucose > 7.7 mmol/l  independent			1.70 (1.40 to 2.80)	4 (2 to 7)
	congestive heart failure  independent			2.60 (1.70 to 4.10)	2 (1 to 4)
	lacunar syndrome  independent			0.56 (0.32 to 0.92)	-4 (-21 to -3)
ischaemic stroke a	urinary incontinence  independent	death at 1 year	?20%	7.32 (2.52 to 21.3)	1 (1 to 3)
	unpartnered marital status  independent			2.42 (1.08 to 5.43)	4 (1 to 62)

A worsening stroke increases mortality

Patient	Outcome	% (95% CI)	NNF (95% CI)
first ischaemic stroke a	early neurological improvement  at 30 days	22% (16% to 29%)	5 (3 to 6)
	mortality in improving patients  at 30 days	2.9% (-2.7% to 8.6%)	34 (12 to inf)
	mortality in stable patients  at 30 days	17% (8.7% to 25%)	6 (4 to 11)
	mortality in deteriorating patients  at 30 days	38% (22% to 55%)	3 (2 to 5)