Factors Associated with Long-term Stroke Mortality

Stroke is one of the leading causes of mortality across the globe. In this study, researchers evaluated the baseline clinical, laboratory, demographic, socioeconomic, and hospital factors associated with five-year mortality in first-time stroke patients. To conduct their research, the study authors linked data from the Chang Gung Research Database (CGRD) to the National Health Insurance Research Database (NHIRD) in Taiwan. The CGRD encompassed data from the 3,600-bed Linko Chang Gung Memorial Hospital (CGMH) medical center, the 2,600-bed Kaohsiung CGMH medical center, the 1,300-bed Chiayi CGMH regional hospital, and the 750-bed Keelung CGMH regional hospital. Medical information on stroke patients from the four hospitals between 2004 and 2008 were evaluated; data were obtained by the first diagnosis code at discharge from the International Classification of Diseases, 9th edition, Clinical Modification (ICD-9-CM codes 430–434). Data from the NHIRD were obtained using the first diagnosis code at discharge (ICD-9-CM codes 430–434) for stroke patients from 1997 to 2013. Incidences of subarachnoid and intracerebral hemorrhage were combined as hemorrhagic stroke, while cerebral infarction was represented as ischemic stroke. Final analysis included a total of 3,956 patients. The following factors were associated with increased mortality in stroke patients: body mass index (BMI) < 18.5 kg/m2, Glasgow Coma Scale score < 15, Stroke Severity Index score ≥ 20, Charlson–Deyo Comorbidity Index score 1–2 or ≥ 3, no rehabilitation during first-stroke hospitalization, blood sugar < 3.89 mmol/L (70 mg/dL), hemoglobin < 120 g/L, red cell distribution width > 0.145, serum creatinine > 112.27 μmol/L, serum sodium < 134 mmol/L, and age ≥ 65 years. BMI ≥ 25 kg/m2 and hemorrhagic stroke were both associated with a decreased mortality risk.

Source: Chen CM, Lee M, Yang YH, et al. Sci Rep. 2019; doi: 10.1038/s41598-019-47975-y