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Mortality-specific comorbidity among inpatients with ischemic stroke in West China
Yang Si1,2, Xiaoqiang Xiao1,2,3, Shunju Xiang4
1Department of Neurology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.
Insights
Hospitalized ischemic stroke patients frequently have comorbidities like peripheral vascular disease and diabetes, increasing mortality risk, especially in the elderly. Early management of these conditions is crucial for better outcomes.
Area of Science:
- Clinical Medicine
- Cardiology
- Neurology
Background:
- Ischemic stroke (IS) is a leading cause of mortality and disability worldwide.
- Comorbidities significantly impact the prognosis and management of IS patients.
- Understanding the prevalence of mortality-specific comorbidities is essential for risk stratification.
Purpose of the Study:
- To investigate the prevalence and patterns of mortality-specific comorbidities in hospitalized ischemic stroke patients.
- To assess the distribution of the Charlson Comorbidity Index (CCI)-based prognostic score in this population.
- To identify key comorbidities contributing to mortality in ischemic stroke.
Main Methods:
- Retrospective analysis of five-year hospital medical data for ischemic stroke inpatients.
- Evaluation of eighteen mortality-specific comorbidities using the Charlson Comorbidity Index (CCI).
- Calculation of the CCI-based prognostic score distribution.
Main Results:
- A total of 10,331 ischemic stroke cases were analyzed.
- The most prevalent comorbidities included peripheral vascular disease (35.1%), uncomplicated diabetes (25.2%), and mild liver disease (18.3%).
- Elderly patients (≥65 years) showed a high prevalence of comorbidities, with 31.1% having a CCI score ≥3.
Conclusions:
- Peripheral vascular disease, diabetes, liver disease, chronic pulmonary disease, congestive heart failure, and atrial fibrillation are major contributors to mortality in hospitalized IS patients.
- A significant proportion of elderly IS patients (one-third) present with a high mortality risk (CCI score ≥3).
- Proactive prevention and management of these comorbidities are critical for reducing mortality in ischemic stroke.
Objective:
This study aimed to investigate the current condition of mortality-specific comorbidity among hospitalized patients with ischemic stroke.
Methods:
Five-year data of inpatients with ischemic stroke (IS) were extracted from the hospital medical database. A retrospective review of eighteen mortality-specific comorbidities in extensively validated Charlson Comorbidity Index (CCI) was carried out for each patient. In addition, the distribution of the CCI-based prognostic score was calculated.
Results:
A total of 10 331 (male 57.6%) cases with IS were recruited in the present study. The most prevalent mortality-specific comorbidities from high to low were as follows: peripheral vascular disease (35.1%), diabetes uncomplicated (25.2%),mild liver disease (18.3%), chronic pulmonary disease (14.7%), congestive heart failure (10.8%), atrial fibrillation or flutter (10.3%), diabetes complicated (9.1%), moderate or severe renal disease (7.5%), and dementia (7.1%). High prevalence of comorbidities in the elderly was also noted (31.1% patients with score ≥3). Spearman correlation analysis with a rho of 0.25 (P < 0.001) showed a mild correlation between the age- and the CCI-based prognostic score.
Conclusion:
High prevalence of peripheral vascular disease, diabetes, liver disease, chronic pulmonary disease, congestive heart failure, atrial fibrillation, or flutter as major contributors to mortality was presented in in-hospital patients with IS in our area. One-third of old patients with IS expose high mortality risk with the CCI score ≥3. Early prevention and management of the potential comorbidities are necessary to reduce the mortality.
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