title: Atrial fibrillation is a predictor of in-hospital mortality in ischemic stroke patients.
abstract: OBJECTIVE
  In-hospital mortality rate of acute ischemic stroke patients remains between 3% and 18%. For improving the quality of stroke care, we investigated the factors that contribute to the risk of in-hospital mortality in acute ischemic stroke patients.
  
  
  METHODS
  Between January 1, 2007, and December 31, 2011, 2,556 acute ischemic stroke patients admitted to a stroke unit were included in this study. Factors such as demographic characteristics, clinical characteristics, comorbidities, and complications related to in-hospital mortality were assessed.
  
  
  RESULTS
  Of the 2,556 ischemic stroke patients, 157 received thrombolytic therapy. Eighty of the 2,556 patients (3.1%) died during hospitalization. Of the 157 patients who received thrombolytic therapy, 14 (8.9%) died during hospitalization. History of atrial fibrillation (AF, P<0.01) and stroke severity (P<0.01) were independent risk factors of in-hospital mortality. AF, stroke severity, cardioembolism stroke, and diabetes mellitus were independent risk factors of hemorrhagic transformation. Herniation and sepsis were the most common complications of stroke that were attributed to in-hospital mortality. Approximately 70% of in-hospital mortality was related to stroke severity (total middle cerebral artery occlusion with herniation, basilar artery occlusion, and hemorrhagic transformation). The other 30% of in-hospital mortality was related to sepsis, heart disease, and other complications.
  
  
  CONCLUSIONS
  AF is associated with higher in-hospital mortality rate than in patients without AF. For improving outcome of stroke patients, we also need to focus to reduce serious neurological or medical complications.
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital; Department of Nursing, Chung Jen Junior College of Nursing, Health Science and Management, Chiayi.
authors.forename: Cheung-Ter
authors.initials: CT
authors.lastname: Ong
authors.affiliation: Department of Family Medicine, Chia-Yi Christian Hospital, Chiayi, Taiwan, Republic of China.
authors.forename: Yi-Sin
authors.initials: YS
authors.lastname: Wong
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital.
authors.forename: Chi-Shun
authors.initials: CS
authors.lastname: Wu
authors.affiliation: Department of Neurology, Chia-Yi Christian Hospital.
authors.forename: Yu-Hsiang
authors.initials: YH
authors.lastname: Su
keywords: atrial fibrillation; brain infarction; outcome; risk factors; thrombolytic therapy