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Factors predicting 30-day mortality in the Warsaw stroke registry
D Ryglewicz1, D B Hier, T Weissbein
1Department of Cerebrovascular Diseases, Institute of Psychiatry and Neurology, Warsaw, Poland; Department of Neurology, University of Illinois at Chicago, Chicago, IL, U.S.A.
Summary
Stroke mortality in Warsaw is high due to increased medical comorbidities, not stroke severity. Factors like age, consciousness, and heart failure predict 30-day mortality in ischemic stroke patients.
Area of Science:
- Neurology
- Epidemiology
- Public Health
Background:
- Poland experiences high stroke mortality and morbidity.
- A 1991-1992 Warsaw study revealed stroke incidence similar to Europe but significantly higher 30-day mortality rates.
Purpose of the Study:
- To identify independent predictors of 30-day mortality in stroke patients in Warsaw.
- To compare stroke characteristics and comorbidities between Warsaw and the US Stroke Data Bank (SDB).
Main Methods:
- Prospective, population-based study of first-ever-in-a-lifetime strokes in Warsaw (1991-1992).
- Logistic regression analysis to determine predictors of 30-day mortality for ischemic stroke (IS) and intracerebral hemorrhage (ICH).
- Comparison of Warsaw Stroke Registry data with the US Stroke Data Bank.
Main Results:
- For IS, 7 predictors of 30-day mortality were identified: increasing age, decreased consciousness, extraocular movement disorder, motor weakness severity, congestive heart failure, kidney diseases, and COPD.
- For ICH, 2 predictors were identified: extraocular movement disorders and decreased consciousness.
- The Warsaw population exhibited higher prevalences of heart disease and COPD compared to the SDB, with more severe consciousness disorders at stroke onset.
Conclusions:
- Medical comorbidity, particularly heart disease and COPD, likely contributes to higher short-term stroke mortality in Warsaw compared to the US.
- Stroke severity and type were comparable, suggesting comorbidity is the key differentiator for poor prognosis.