Assessment of nursing care-associated predictors of in-hospital mortality in the patients with acute ischemic stroke

Background: Stroke remains one of the leading causes of death and disability worldwide. Aim: To determine nursing care-associated predictors of in-hospital mortality in patients with acute ischemic stroke (AIS) who were hospitalized at the Department of Emergency Neurology. Methods: Prospective cohort study included 59 consecutive patients with AIS admitted to Department of Emergency Neurology, Neurology Clinic Center of Serbia, Belgrade. Patients were followed until discharge or death. For exploring relationship between outcome of patients with AIS and different groups of factors, univariate and multivariate Cox proportionate hazard regression models were used. Results: There were 32 male and 27 female patients with AIS. Mean age was 62.5±15.2 years. Average duration of hospitalization was 11.1 ± 9.6 days (median 8 days, range 1-54 days). Almost 80% of patients (47/59, 79.7%) were admitted to stroke unit, while 12 patients (20.3%) were admitted to intensive care unit. In univariate Cox regression analysis significant variables (p<0.05) were Morse score (p=0.030) and type of admission unit (p=0.029). The multivariate predictive model revealed that type of admission unit (stroke unit vs. conventional unit) (HR=0.16, p=0.032) is the independent predictor of in-hospital mortality in patients with AIS. Conclusion: Results of this study showed important role of nursing staff in AIS patients’ recovery, as well as that admission to stroke units versus conventional units is independent predictor of decreased in-hospital mortality.