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Predictors of early mortality after acute ischaemic stroke.
- Source :
-
Swiss medical weekly [Swiss Med Wkly] 2010 May 01; Vol. 140 (17-18), pp. 254-9. - Publication Year :
- 2010
-
Abstract
- Background: The study set out to identify clinical, laboratory and radiological predictors of early mortality after an acute ischaemic stroke (AIS) and to analyse medical and neurological complications that caused death.<br />Methods: A total of 479 consecutive patients (mean age 63+/-14 years) with AIS underwent stroke examination and treatment. Examination included clinical evaluation, laboratory tests, and brain CT and/or MRI. Follow-up data at 30 days were available for 467 patients (93%) who were included in the present analysis.<br />Results: The median National Institute of Health Stroke Study (NIHSS) score on admission was 6. A total of 62 patients (13%) died within 30 days. The cause of death was the initial event in 43 (69%), pneumonia in 12 (19%), intracerebral haemorrhage in 9 (15%), recurrent stroke in 6 (10%), myocardial infarction in 2 (3%), and cancer in 1 (2%) of the patients. In univariate comparisons, advanced age (p<0.001), hypertension (p=0.013), coronary disease (p=0.001), NIHSS score (p<0.001), undetermined stroke etiology (p=0.031), relevant co-morbidities (p=0.008), hyperglycemia (p<0.001), atrial fibrillation (p<0.001), early CT signs of ischemia (p<0.001), dense artery sign (p<0.001), proximal vessel occlusion (p<0.001), and thrombolysis (p=0.008) were associated with early mortality. In multivariate analysis, advanced age (HR=1.12; 95% CI 1.05-1.19; p<0.001) and high NIHSS score on admission (HR=1.15, 95% CI 1.05-1.25; p=0.002) were independent predictors of early mortality.<br />Conclusions: We report 13% mortality at 30 days after AIS. More than two thirds of the deaths are related to the initial stroke. Advanced age and high NIHSS score are the only independent predictors of early mortality in this series.
- Subjects :
- Adolescent
Adult
Age Factors
Aged
Aged, 80 and over
Brain Ischemia diagnosis
Brain Ischemia drug therapy
Confidence Intervals
Female
Health Status Indicators
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate Analysis
Prognosis
Proportional Hazards Models
Prospective Studies
Regression Analysis
Risk Assessment
Risk Factors
Stroke diagnosis
Stroke drug therapy
Switzerland epidemiology
Tomography, X-Ray Computed
Treatment Outcome
Young Adult
Brain Ischemia mortality
Stroke mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1424-3997
- Volume :
- 140
- Issue :
- 17-18
- Database :
- MEDLINE
- Journal :
- Swiss medical weekly
- Publication Type :
- Academic Journal
- Accession number :
- 20104376
- Full Text :
- https://doi.org/smw-12919