To Determine the Mortality and Factors Responsible for Mortality in Patients Presenting with Acute Stroke within 5 Days of Admission at a Tertiary Care Hospital Hyderabad/Jamshoro

Abstract

Introduction: Stroke is the third most common cause of death and the first leading cause of disability in developed and developing countries. Various clinical variables have been implicated as predictors of final outcome of acute stroke. These predictors are demographic characteristics, types of stroke, co-morbidities and therapy. Identification of modifiable predictors of death is of paramount importance for clinicians in resource poor-setting, so that specific therapies and management strategies can be applied to patients at high risk of dying. Objective: To determine the mortality and factors responsible for mortality in patients presenting with acute stroke within 5 days of admission at a tertiary care Hospital,  Hyderabad/Jamshoro. Setting: Medical Unit-I, Liaquat University Hospital, Hyderabad/Jamshoro. Duration: Six months from   01-02-2019 to 31-07-2019 Design: prospective, (non -interventional) study. Subject and Methods: Two hundred and fourteen acute stroke patients confirmed by CT scan brain were included in the study. Patients were assessed through history and examination and brief history was taken about the disease and cigarette smoking. Blood Pressure was measured twice. Patients who died during admission were evaluated for the factors responsible for the mortality. The findings of variables were entered in a Pro forma. Results: The average age of the patients was 55.65±8.38 years. Frequency of mortality in patients presenting with acute stroke within 5 days of admission in hospital was observed in 29.91% (64/214) cases. Regarding factors leading to mortality, Rate of mortality was 23 times more like in those patients who had dyslipidemia [OR= 23.13 95%CI= 1.86 to 7.98] similarly mortality in patients was 2 to 4 times more likely in diabetic, hypertensive cases and smokers. Conclusion: Frequency of mortality was high and factors leading to mortality within 5 days were dyslipidemia, diabetic, hypertensive cases. Mortality associated with acute stroke needs prevention and control of risk factors. Treatment and control of diabetes mellitus and hyperlipidemia have contributed to the stroke mortality declines; however, the onset of these interventions is more recent, and thus their impact is less clear.