Long-term outcome after stroke in Belarus: the Grodno stroke study.

BACKGROUND AND PURPOSE Data concerning the long-term prognosis after stroke in low-income and middle-income countries are limited. We aimed to establish survival and dependency at 5 years after a first-ever-in-a-lifetime stroke in Grodno, Belarus. METHODS All residents of Grodno with a suspected acute stroke were registered prospectively and assessed over a period of 12 months in 2001. Patients were followed-up prospectively at 3 and 12 months, and then annually up to 5 years after the index event. RESULTS There were 671 cases of first-ever-in-a-lifetime stroke, and follow-up data after 5 years were available for 653 of these patients (97.3%); 18 people (2.7%) were lost to follow-up. One hundred ninety patients (29.1%) died during the first 28 days of stroke. The case fatality rate at 3 months was 32.2% (210/653), at 12 months it was 37.4% (244/653), and at 5 years it was 58.8% (384/653). Of the 269 survivors at 5 years, 130 (48.3%) were independent (modified Rankin score, 0-2), and 139 (51.7%) were disabled (modified Rankin score, ≥3). At 5 years, the cumulative risk of death or disability after first-ever-in-a-lifetime stroke was 80.1% (523/653). CONCLUSIONS Stroke in Belarus is associated with a very high risk of death or dependency at 5 years.