title: Trends in one-year mortality for stroke in a tertiary academic center in Saudi Arabia: a 5-year retrospective analysis.
abstract: BACKGROUND
  Numerous studies have reported a decline in stroke-related mortality in developed countries.
  
  
  OBJECTIVE
  To assess trends in one-year mortality following a stroke diagnosis in Saudi Arabia.
  
  
  METHODS
  Retrospective longitudinal cohort study.
  
  
  METHODS
  Single tertiary care center from 2010 through 2014.
  
  
  METHODS
  All patients admitted with a primary admitting diagnosis of stroke.
  
  
  METHODS
  Demographic data (age, gender, nationality), risk factor profile, stroke subtypes, in-hospital complications and mortality data as well as cause of death were collected for all patients. A multivariable logistic regression model was used to assess factors associated with one-year mortality following a stroke admission.
  
  
  METHODS
  One-year mortality.
  
  
  RESULTS
  In 548 patients with a mean age of 62.9 years (SD 16.9), the most frequent vascular risk factors were hypertension (90.6%), diabetes (65.5%), and hyperlipidemia (27.2%). Hemorrhagic stroke was diagnosed in 9.9%. The overall mortality risk was 26.9%. Non-Saudis had a significantly higher one-year mortality risk compared with Saudis (25% vs. 16.8%, respectively; P=.025). The most frequently reported causes of mortality were neurological and related to the underlying stroke (32%), sepsis (30%), and cardiac or other organ dysfunction-related (each 9%) in addition to other etiologies (collectively 9.5%) such as pulmonary embolism or an underlying malignancy. Significant predictors in the multivariate model were age (P < .0001), non-Saudi nationality (OR 1.8, CI 95 1.1 to 2.9; P=.019), and hospital length of stay (OR 1.01, CI 95 1 to 1.004; P=.001).
  
  
  CONCLUSIONS
  We observed no decline in stroke mortality in our center over the 5-year span. The establishment of stroke systems of care, use of thrombolytic agents, and opening of a stroke unit should play an important role in a decline in stroke mortality.
  
  
  CONCLUSIONS
  Retrospective single center study. Mortality data were available only for patients who died in our hospital.
authors.affiliation: Dr. Mohammed Almekhlafi, Department of Internal Medicine,, Division of Neurology,, King Abdulaziz University,, PO Box 80215, Jeddah, 21589, Saudi Arabia, malmekhlafi@kau.edu.sa, ORCID ID: orcid.org/0000-0001-9550-8197.
authors.forename: Mohammed A
authors.initials: MA
authors.lastname: Almekhlafi
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology / Q000639:trends; D009369:Neoplasms / Q000401:mortality; D009422:Nervous System Diseases / Q000401:mortality; D011655:Pulmonary Embolism / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D018805:Sepsis / Q000401:mortality; D020521:Stroke / Q000208:ethnology / Q000401:mortality*; D062606:Tertiary Care Centers; D013997:Time Factors