Stroke is of great medical concern worldwide, being the 6th most common cause of adult disability and second leading cause of death. Chronic Obstructive Pulmonary Disease (COPD) is a similarly important cause of mortality and morbidity. The World Health Organisation (WHO) predictions place COPD as the third most common cause of death by the year 2020. There is some pathophysiological overlap between COPD, asthma and bronchiectasis.Many studies exist which examine stroke incidence and mortality. Fewer studies explore other outcomes or the impact of specific comorbidities on outcomes.The aim of this thesis is to determine whether COPD, asthma and bronchiectasis have a bearing on the survival of patients hospitalised with their first stroke in Scotland.157,639 individuals were included in the study, 44.9% of whom were male. 58.1% of all patients had one or more comorbidities and 6.9% had a respiratory comorbidity. 74.1% of all patients survived for 30 days following stroke. 58.1% survived for 1 year and 35.2% for 5 years. The proportions of patients with a comorbid respiratory condition surviving were 71.8% at 30 days, 53.5% at 1 year and 25.9% at 5 years. Median survival for all patients was 818 days. For those with no respiratory comorbidity, median survival was 851 days. For patients with a respiratory condition, median survival was 501 days. Median survival was consistently worse for individuals with a respiratory comorbidity, when further examined by age and deprivation category. The difference in survival was more marked in the younger age groups.A respiratory comorbidity adversely and significantly affects the outcome, in terms of survival, following first stroke. The reasons for this are not entirely clear and more studies are needed to evaluate this effect further.
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The effect of chronic lower respiratory tract disease on survival of patients hospitalised with stroke in Scotland
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