title: Case-fatality and functional status three months after first-ever stroke in Vietnam.
abstract: BACKGROUND
  To provide novel information on outcomes after first-ever stroke in Vietnam, case-fatality and functional status were assessed 3months after stroke onset.
  
  
  METHODS
  First-ever stroke patients admitted to the stroke unit of a tertiary teaching hospital in Ho Chi Minh City, Vietnam were recruited, examined and interviewed. Functional status was assessed on the modified Rankin Scale (mRS) at admission and again at 3months.
  
  
  RESULTS
  We recruited 450 consecutive first-ever stroke patients (99.6% participation, 47.9% female, mean age 62.5 [SD 14.0] years, 76.2% ischaemic stroke). Three-month observed case-fatality was 10.4%. Under plausible assumptions about deaths among non-recruited participants, the estimated case-fatality would be higher (16.4%) Those who had died were mostly older patients compromised by comorbidities and pre-existing disability, and who had severe impairment or severe disability due to stroke at the time of admission. At 3-month follow-up of 376 patients, 34% had least severe disability (mRS=0/1), 39% had intermediate disability and 28% had most severe disability (mRS=4/5). Those with least severe disability were mostly men younger than 65years of age and principally with ischemic stroke. Those with most severe disability were predominantly women aged ≥65years and those with severe disability, mainly attributable to intracerebral haemorrhage. At 3months, 50% had better functional status than at stroke onset, and 27% had poorer function.
  
  
  CONCLUSIONS
  Case-fatality was relatively low in this study, possibly because of cultural preferences for end-of-life care at home. The dependency burden was relatively high, placing pressure on the healthcare system and society.
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Viet Nam.
authors.forename: Tran L
authors.initials: TL
authors.lastname: Pham
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia. Electronic address: Leigh.Blizzard@utas.edu.au.
authors.forename: Leigh
authors.initials: L
authors.lastname: Blizzard
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; Stroke and Ageing Research Centre, School of Clinical Sciences, Monash University, Melbourne, Australia.
authors.forename: Velandai
authors.initials: V
authors.lastname: Srikanth
authors.affiliation: Stroke and Ageing Research Centre, School of Clinical Sciences, Monash University, Melbourne, Australia; Stroke Division, The Florey Institute of Neuroscience and Mental Health, Heidelberg, Australia.
authors.forename: Amanda G
authors.initials: AG
authors.lastname: Thrift
authors.affiliation: Stroke Unit, Cerebrovascular Disease Department, 115 People's Hospital, Ho Chi Minh City, Viet Nam.
authors.forename: Nguyen T K
authors.initials: NT
authors.lastname: Lien
authors.affiliation: Stroke Unit, Cerebrovascular Disease Department, 115 People's Hospital, Ho Chi Minh City, Viet Nam.
authors.forename: Nguyen H
authors.initials: NH
authors.lastname: Thang
authors.affiliation: Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
authors.forename: Seana L
authors.initials: SL
authors.lastname: Gall
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000401:mortality; D015331:Cohort Studies; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012720:Severity of Illness Index; D012737:Sex Factors; D020521:Stroke / Q000401:mortality*; D062606:Tertiary Care Centers; D013997:Time Factors; D014744:Vietnam / Q000453:epidemiology
keywords: Case-fatality; First-ever; Functional status; Stroke; Vietnam