In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia
| Autor: | Razia Aftab, Nabil J. Awadalla, Khaled Katramiz, Shamsun N. Khalil, Aesha Faraheen, Ahmed Y Abolyazid, Adel Alhazzani, Ahmed A. Mahfouz |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Health Toxicology and Mutagenesis lcsh:Medicine Kaplan-Meier Estimate 0302 clinical medicine Risk Factors Case fatality rate Hospital Mortality 030212 general & internal medicine first-time stroke in-hospital mortality case fatality determinants Saudi Arabia Stroke Aged 80 and over education.field_of_study Mortality rate Smoking Hazard ratio Age Factors Middle Aged Prognosis Pulmonary embolism Hypertension Regression Analysis Female Adult medicine.medical_specialty Population Article 03 medical and health sciences Sex Factors Internal medicine medicine Humans Mobility Limitation education Survival analysis Aged Proportional Hazards Models Proportional hazards model business.industry lcsh:R Public Health Environmental and Occupational Health medicine.disease Multivariate Analysis Pulmonary Embolism business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | International Journal of Environmental Research and Public Health; Volume 15; Issue 5; Pages: 927 International Journal of Environmental Research and Public Health International Journal of Environmental Research and Public Health, Vol 15, Iss 5, p 927 (2018) |
| ISSN: | 1660-4601 |
| Popis: | Objectives: The present study analyzed in-hospital first-time stroke mortality in southwestern Saudi Arabia over one-year to assess the in-hospital stroke case fatality rate, mortality rate and explore the factors associated with in-hospital stroke mortality. Study Design: Hospital based follow-up study. Methods: First-time stroke patients admitted to all hospitals in Asser region over one-year period (January through December 2016) were included in the study. Data about personal characteristics, pre-stroke history and clinical criteria, on admission clinical criteria, in-hospital complications and survival status were collected. The last reported Aseer region population was used to calculate age and sex stroke mortality rate per 100,000 population/year. Hazard ratios (HR) and concomitant 95% confidence intervals (95% CI) were computed using multivariate Cox regression survival analysis. Kaplan-Meier curve survival analysis for stroke patients were plotted. Results: A total of 121 in-hospital deaths out of 1249 first-time stroke patients giving an overall case fatality rate (CFR) of 9.7%. Non-significant difference with gender and age were observed in CFR. Overall, in-hospital stroke mortality rate was 5.58 per 100,000/year. Males and elders showed a significantly higher mortality rates. Multivariable Cox regression analyses revealed pre-stroke smoking (HR = 2.36), pre-stroke hypertension (HR = 1.77), post-stroke disturbed consciousness (HR = 6.86), poor mobility (HR = 2.60) and developing pulmonary embolism (HR = 2.63) as significant predictors of in-hospital stroke mortality. Conclusions: In Southwestern Saudi Arabia, the in-hospital stroke mortality rate is higher in men and increases with aging. The prognosis of acute stroke could be improved by smoking cessation, better control of hypertension and prevention of in hospital complication particularly pulmonary embolism. |
| Databáze: | OpenAIRE |
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