Analysis of 30-day stroke mortality in a community-based registry in Warsaw, Poland

Between January 1, 1991, and December 31, 1992, in the upper Mokotow district of Warsaw, Poland (population 182,285), 462 first-ever-in-a-lifetime (FEL) strokes were registered, 12% (55/462) with parenchymatous intracerebral hemorrhages (PICH) and 88% (407/462) with ischemic strokes. Confirmation by either computed tomography or autopsy was made in 72.3% of cases. The overall 30-day case fatality rate (CFR) for FEL strokes was 40% (186/462), 60% for PICH (33/55), and 38% for ischemic stroke (153/407). Of the 186 patients who died within 30 days of their FEL stroke, 49% (91) underwent full autopsy examination. Fifty-two percent of these 91 patients were found to have died from direct neurological sequelae, 21% from cardiac causes, 17% from pneumonia, 5.6% from septicemia, 2.2% from pulmonary emboli, and 2.2% from metastatic cancer. Despite our high 30-day stroke CFR compared with Western Europe and North America, mechanisms of death were similar.