Predictors of unfavorable outcome and in-hospital mortality after ischemic stroke
Background: stroke is the second leading cause of death and disability worldwide. The most significant factors for early mortality are age, severity of stroke (NIH stroke scale), atrial fibrillation (AF) and hypertension. Objective: elucidate the factors correlated with unfavorable outcome and mortality after ischemic stroke. Design/Setting: retrospective descriptive study conducted at the Botucatu Medical School Hospital. Methods: this study included 515 stroke patients, aged at least 18, admitted to ICU and stroke-unit between January/2017-December/2018. Baseline data, comorbidities and risk factors were collected and relation to unfavorable outcome and in-hospital mortality were evaluated. Unfavorable outcome was defined as dependency (modified Rankin Scale mRs 4–5). Results: overall, in-hospital mortality rate was 15% (77) and unfavorable outcome 36.7% (189). The patients average age was 69.18±13.08, and NIHSS at admission 9.27±8.41. NIHSS at admission and pre-morbid mRs were independently associated with unfavorable outcome, as each NIHSS point was responsible for 22% outcome increase. Both higher NIHSS and AF were independently associated with in-hospital mortality, increasing the death risk 19% and 3.5 times respectively. Conclusion: the main factor associated with overall in-hospital mortality and unfavorable outcome was stroke severity.