PREDICTORS OF MORTALITY AFTER ACUTE STROKE A PROSPECTIVE HOSPITAL BASED STUDY

Authors

  • Javed Akhter Rathore
  • Zulfiqar Ali Kango
  • Adnan Mehraj

Abstract

Background: The stroke is third leading cause of death in world and 10% of patients with an acute
ischemic stroke die within 30 days. Various clinical variables have been implicated as predictors of
final outcome of acute stroke. The study was aimed to identify predictors of mortality after an acute
stroke. Material and Methods: This prospective study included 149 consecutive patients of acute
Hospital Muzaffarabad, Azad Kashmir. The outcome as mortality measures used were Modified
Ranking Scale (mRS) and Glasgow Coma Scale (GCS). Examination included clinical, neurological
evaluation, laboratory tests, and brain CT. The follow-ups at 14 days were done for all patients.
Results: Hospital mortality was 17.4 % (26/149) within 14 days. Age and gender had no impact on
mortality. Hypertension (p=0.008), smoking (p=0.056)), brain infarction (p=<0.001), hemorrhagic
stroke (p=<0.001), diabetes (p=0.292), atrial fibrillation (p<0.001), high mRS (p<0.001), low GCS
score (p<0.001), on admission were important predictors of mortality. Conclusions: We report 17.4%
mortality at 14 days. Mortality associated with acute stroke needs prevention and control of risk factors.
Keywords: acute stroke; predictors; mortality, Glasgow Coma Scale, Modified Ranking Scale

References

Carandang R, Seshadri S, Beiser A, Kelly-Hayes M, Kase CS,

Kannel WB, et al. Trends in incidence, lifetime risk, severity, and

-day mortality of stroke over the past 50 years. JAMA 2006;

:2939-46.

Rothwell PM, Coull AJ, Giles MF, Howard SC, Silver LE, Bullet

LM, et al. Change in stroke incidence, mortality, case-fatality,

severity, and risk factors in Oxfordshire, UK from 1981 to 2004

(Oxford Vascular Study). Lancet 2004; 363:1925-33.

Kasper DL, Braunwald E, Fauci AS, Hauser SL, Longo DL,

Jameson JL, et al. editors. Harrison's Principles of Internal

Medicine. 16th ed. New Delhi: McGraw-Hill, Medical Publishing

Division; 2005.p. 2372-93

Bhalla A, Gupta IO, Gupta SB. Predicting mortality in stroke.

Neural India 2002; 50:279-81.

Roberts L, Counsel C. Assessment of Clinical Outcomes in

Acute Stroke Trials. Stroke 1998; 29:986-91.

Heuschmann PU, Kolominsky-Rabas PL, Misselwitz B,

Hermanek P, Leffmann C, Janzen RW, et al. Predictors of inhospital mortality and attributable risks of death after ischemic

stroke: the German Stroke Registers Study Group. Arch Intern

Med 2004; 164:1761-8.

Okumura K, Ohya Y, Maehara A, Wakugami K, Iseki K,

Takishita S. Effects of blood pressure levels on case fatality after

acute stroke. J Hypertens 2005;23:1217-23.

Sulter G, Steen C, De Keyser J. Use of the Barthel Index and

Modified Rankin Scale in stroke trials. Stroke 1999; 30:1538-41.

Weir CJ, Bradford APJ, Lees KR. The Prognostic value of the

GCS following acute stroke. QJ Med 2003; 96:67-74.

Hatano S. Control of stroke in the community, Methodological

consideration and protocol of WHO stroke register. Geneva

WHO 1973; 98. Document No. CVD/S/73.

Sandercock PAG, Warlow CP, Starky IR. Predisposing factors

for cerebral infarction: the Oxfordshire community stroke project.

BMJ 1989; 298:75-80.

Caroline TM, Mackerback JP. Socioeconomic difference in

stroke among Dutch elderly women. Stroke 1999; 30:357-62.

Hamidon BB, Raymond AA. The Impact of diabetes mellitus on

in-hospital stroke mortality. J Postgraduate Med 2003; 49:307-

Togha M, Bakhtavar K. Factors associated with in-hospital

mortality following intracerebral haemorrhage: a three-year study

in Tehran, Iran. BMC Neurology 2004; 4:9-11.

Razzak AA, Khan BA, Baig SM. Ischemic strokes in young

adults of South Asia. J Pak Med Assoc 2002; 52:417-22.

Fayyaz M, Hassan MA, Atique MH. Risk factors and early

prognosis in stroke. Ann King Edward Med Coll 1999;5(1):12-5.

Sarti C, Rastenyte D, Cepaitis Z, Tuomilehto J. International

trends in mortality from stroke, 1968 to 1994. Stroke 2000;

:1588-601.

Kelly-Hayes M, Wolf PA, Kannel WB, Sytkowski P,

D'Agostino RB, Gresham GE. Factors influencing survival and

need for institutionalization following stroke: the Framingham

Study. Arch Phys Med Rehabil 1988; 69:415-8.

Anderson C, Jamrozik K, Stewart-Wynne E. Predicting survival

after stroke: experience from the Perth Community Stroke Study.

Clin Exp Neurol 1992; 29:117-28.

Sheikh K, Brennan P, Meade T, Smith D, Goldenberg E.

Predictors of mortality and disability in stroke. J Epidemiol

Community Health 1983; 37:70-4.

Ebell MH. Predicting prognoses in patients with acute

stroke. Am Family Phys 2008; 77:1719-20.

Li C, Engstrom G, Hedblad B, Berglund G, Janzon L. Blood

pressure control and risk of stroke. A population based

prospective cohort study. Stroke 2005; 36:725-30. Epub 2005.

Jafar TH. Blood pressure, diabetes and increased dietary salt

associated with stroke -results from a community-based study

in Pakistan. J Hum Hypertens 2006; 20(1):83-5.

Ahmed R, Shakir AH, Moizuddin SS, Haleem A, Ali S, Durani

K, et al. Predictors of in hospital mortality for intracerebral

hemorrhage: A hospital based study in Pakistani adults. J Stroke

Cerebrovasc Dis 2001; 10:122-7.

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Published

2011-06-01

How to Cite

Rathore, J. A., Kango, Z. A., & Mehraj, A. (2011). PREDICTORS OF MORTALITY AFTER ACUTE STROKE A PROSPECTIVE HOSPITAL BASED STUDY. Journal of Ayub Medical College Abbottabad, 23(2), 144–146. Retrieved from https://demo.ayubmed.edu.pk/jamc/index.php/jamc/article/view/2556

Issue

Vol. 23 No. 2 (2011): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

Section

ORIGINAL ARTICLE

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