High case-fatality rates in the Warsaw stroke registry

Area of Science:

• Neurology
• Public Health
• Epidemiology

Background:

• 1-year survival rates for first-event-in-lifetime ischemic stroke (FEL-IS) in Warsaw are notably high compared to other industrialized countries.
• Early mortality is linked to direct neurological sequelae and immobility complications, whereas late mortality is associated with stroke recurrence and immobility complications.

Purpose of the Study:

• To determine 1-year survival rates and identify predictors of mortality in patients with FEL-IS in Warsaw.
• To compare case fatality rates with those in other industrialized nations.

Main Methods:

• Analysis of 1-year survival data from 297 patients with FEL-IS in a population-based study in Warsaw.
• Life table methods were employed to analyze predictors of survival.

Main Results:

• The 30-day and 1-year case fatality rates were 29% and 51%, respectively.
• Adverse predictors of 1-year survival included advanced age, low activities of daily living scores, atrial fibrillation, weakness, congestive heart failure, and untreated hypertension.
• Stroke recurrence significantly increased the likelihood of death within the first year.

Conclusions:

• High case fatality rates in Poland may be attributed to stroke severity, leading to neurological sequelae and immobility complications.
• Medical comorbidity likely exacerbates high case fatality rates by increasing stroke recurrence and immobility-related deaths.
• Improved stroke patient rehabilitation and better management of medical comorbidities are hypothesized to reduce mortality rates in Poland.