Open AccessPredictors of in‐hospital mortality after ischemic stroke: A prospective, single‐center study
Author(s) -
KortazarZubizarreta Izaro,
PinedoBrochado Ana,
AzkuneCalle Itxaso,
AguirreLarracoechea Urko,
GomezBeldarrain Marian,
GarciaMonco Juan Carlos
Publication year - 2019
Publication title -
health science reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.462
H-Index - 7
ISSN - 2398-8835
DOI - 10.1002/hsr2.110
Subject(s) - medicine , stroke (engine) , prospective cohort study , odds ratio , emergency medicine , neurology , mortality rate , single center , pediatrics , mechanical engineering , psychiatry , engineering
Abstract Background and Aims Stroke is the second leading cause of death around the globe. Studies examining the predictors of in‐hospital mortality and the impact of complications on early outcome of acute ischemic stroke are scant. The aim of this study was to identify predictors of in‐hospital mortality in patients with acute ischemic stroke. Methods This was a prospective, single‐center study of patients with acute ischemic stroke consecutively admitted to the Neurology Department of a general hospital during a 2‐year period (from January 1, 2010 to December 31, 2011). Prospective data from this single‐center study included variables related to sociodemographics, comorbidities, and medical complications, together with in‐hospital mortality. Since stroke mortality may impact differently by sex and is also influenced by hospital length of stay, we proceeded to stratify by these variables. Results Six‐hundred and seventy‐three patients were included. Overall, in‐hospital mortality rate was 7.13%. Stratifying by length of stay in‐hospital (< 7 days and ≥ 7 days), we observed that within the first week, overall mortality was related to a history of previous stroke, higher stroke severity, and to cardiovascular and respiratory complications. After 7 days, the main factor independently associated with overall in‐hospital mortality was stroke severity (National Institutes of Health Stroke Scale (NIHSS) ≥ 14, odds ratio (OR): 17.15; 95% CI, 3.06‐96.07). Stratifying by sex, we observed that females had a worse outcome if there was a history of prior stroke (OR: 3.29; 95% CI, 1.19‐9.10), higher stroke severity (NIHSS ≥ 14, OR: 16.63; 95% CI, 4.66‐59.31), and cardiovascular complications (OR: 29.70; 95% CI, 5.70‐154.8). Among men, stroke severity (NIHSS ≥ 14, OR: 23.19; 95% CI, 5.69‐94.56), respiratory infections (OR: 3.84; 95% CI, 1.32‐11.20), and older age had significant negative impact. Conclusions Stroke severity and potentially modifiable complications (respiratory infections and cardiovascular complications) confer an increased risk of in‐hospital death in both women and men, particularly during the first week of admission.