Factors predicting 30-day mortality in the Warsaw stroke registry

Poland has high mortality and morbidity due to stroke. Our prospective population-based study conducted in Warsaw in 1991-1992 showed a stroke incidence similar to other European countries. However, 30-day case mortality rates were much higher. Our aim was to explore factors predicting 30-day mortality in Warsaw. The study population consisted of all patients with first-ever-in-a-lifetime strokes admitted to the Department of Cerebrovascular Diseases during the 2-year prospective population-based stroke registry. Cases with uncertain stroke type were excluded from analysis. During the 2-year study period, 633 patients with stroke were registered (462 with first-ever-in-a-lifetime stroke); 351 of them completed full diagnostic procedures, and 297 were diagnosed with ischemic stroke (IS) and 54 with intracerebral hemorrhage (ICH). A logistic regression model for IS identified 7 independent variables predicting 30-day mortality: increasing age, decreased consciousness at the onset of stroke, extraocular movement disorder, severity of motor weakness, congestive heart failure, kidney diseases, and chronic obstructive pulmonary diseases (COPD). A logistic regression model for ICH identified two independent predictor variables: extraocular movement disorders and decreased consciousness. Comparison of the Warsaw Stroke Registry with the Stroke Data Bank (SDB) revealed higher prevalences of heart disease (angina and atrial fibrillation) and COPD in the Warsaw population. Comorbidity of medical diseases with stroke probably contributed to higher mortality in the Warsaw as opposed to U.S.

Disorders of consciousness at the onset of stroke were more severe in Warsaw than in the U.S.

Stroke type, severity of weakness score, and severity of stroke scale were similar for the SDB and Warsaw populations. In Poland, high levels of medical comorbidity rather than stroke severity probably account for poor short-term prognosis in stroke.