Patterns of mortality in modern stroke care

Area of Science:

• Neurology
• Public Health
• Geriatrics

Background:

• Stroke remains a significant cause of mortality globally.
• Understanding in-hospital mortality causes is crucial for improving stroke care.
• This study examines mortality within a contemporary stroke unit setting.

Purpose of the Study:

• To investigate the direct and indirect causes of in-hospital mortality in stroke patients.
• To analyze trends in stroke mortality over a two-year period.
• To identify key factors contributing to death in a modern stroke unit.

Main Methods:

• Retrospective review of medical charts for all stroke deaths between 2014-2015.
• Data collection included stroke type, etiology, patient demographics, length of stay, comorbidities, and documented cause of death.
• Analysis of 39 fatal stroke cases admitted to the stroke service.

Main Results:

• The overall in-hospital mortality rate was 7.5% (39 out of 518 patients).
• Ischemic stroke accounted for 74% of fatal cases, with atrial fibrillation noted in 49% of deaths.
• Pneumonia (49%) and raised intracranial pressure (33%) were the primary causes of death.
• Average age of deceased patients was 78.6 years, with a mean survival of 26.4 days.

Conclusions:

• In-hospital stroke mortality has decreased significantly compared to previous years (15% in 1997).
• Mortality appears to be divided into early events related to Secondary Stroke Related Cerebral Events (SSRCEs) and later-onset infections.
• Infections, particularly pneumonia, and complications like raised intracranial pressure are critical factors in stroke mortality.