Stroke mortality and morbidity in United Kingdom

Chutoo, Padma (2021) Stroke mortality and morbidity in United Kingdom. Doctoral thesis, University of East Anglia.

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Abstract

Stroke is a severe, debilitating, and highly prevalent disease that remains a leading cause of mortality and rising healthcare costs. In the UK, there are approximately 113,000 strokes annually (that is, one every 3 minutes 27 seconds) accounting for around 53,000 deaths (Rothwell et al., 2004). Strokes can be ischaemic or haemorrhagic. About 85% of all strokes are ischaemic and 15% are haemorrhagic (Murphy & Werring, 2020). Transient Ischaemic attack (TIA), often referred to as a “mini-stroke” is regarded as a warning sign for future strokes. The risk of premature death and disability is quite high among stroke survivors. Despite significant progress in prevention, treatments,
and rehabilitation, there is still great capacity for further improvements, which in turn could reduce the large economic burden of stroke.
The aim of the research is to investigate the impact of ischaemic stroke and TIA events on the longterm survival of affected patients in the UK and to estimate the influence of various risk factors (demographical, lifestyle factors, co-morbidities, and treatments) on the hazards of all-cause mortality of stroke survivors.
Electronic medical records from 1986 to 2016 were extracted from The Health Improvement Network (THIN) database and were used to develop survival models for IS and TIA. Weibull Double-Cox models adapted from Begun et al. (2019) with frailty (random effect) term of general practices were used in modelling the survival.
The study found a much higher risk of all-cause mortality among IS survivors and TIA patients compared to their age, sex, and general practice matched controls. Moreover, in both studies, aspirin prescription was found to be associated with positive long-term survival prospects in cases and to be more effective relative to other antiplatelet treatment options. These important findings are of interest to healthcare professionals, actuaries, and other stakeholders and are beneficial for stroke sufferers.

Item Type:	Thesis (Doctoral)
Faculty \ School:	Faculty of Science > School of Computing Sciences
Depositing User:	Nicola Veasy
Date Deposited:	30 Nov 2022 13:50
Last Modified:	30 Nov 2022 13:50
URI:	https://ueaeprints.uea.ac.uk/id/eprint/89972
DOI:

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