Predicting 3-month mortality among patients hospitalized for first-ever acute ischemic stroke.
BACKGROUND
The clinical course of patients with acute ischemic stroke tends to be unstable. Understanding the factors contributing to the progression of stroke is important for the appropriate management of patients. This study investigated the factors related to 3-month mortality at admission in patients with first-ever acute ischemic stroke.


METHODS
Patients with first-ever acute ischemic stroke consecutively admitted to a medical center in Taiwan within 48 hours after stroke onset were prospectively followed-up for 3 months. All deaths during this 3-month post-stroke period were analyzed. We evaluated only those characteristics that could be assessed at admission. Multivariate logistic regression analysis was used to identify the main predictors of 3-month stroke-related mortality.


RESULTS
In the 360 enrolled patients, the inhospital mortality rate was 7.8% (28 deaths), and the 3-month mortality rate was 9.7% (35 deaths). Twenty-seven deaths (77%) were stroke-related. Risk factors for mortality at 3 months included sex (odds ratio [OR], 3.18; 95% confidence interval [CI], 1.08-9.41; p=0.036), National Institutes of Health Stroke Scale (NIHSS) at admission (per unit increase: OR, 1.17; 95% CI, 1.12-1.22; p<0.001), history of cardiac disease (OR, 2.73; 95% CI, 1.04-7.16; p=0.042), and posterior circulation stroke (OR, 5.25; 95% CI, 1.92-14.36; p=0.001).


CONCLUSIONS
This study of hospital-based data on patients with first-ever acute ischemic stroke in Taiwan found that initial NIHSS, posterior circulation stroke and history of cardiac disease were risk factors for 3-month mortality.
Chang
Ku-Chou
KC
Department of Neurology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Tseng
Mei-Chiun
MC
Tan
Teng-Yeow
TY
Liou
Chia-Wei
CW
D000368:Aged; D002545:Brain Ischemia / Q000401:mortality*; D018450:Disease Progression; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology