Clinical Indicators of Mortality and Diminished Functional Recovery in Hospitalized Patients with Acute Stroke

Abstract

Background: Acute stroke poses a significant global health challenge, with substantial morbidity and mortality implications. Recognizing the factors associated with unfavorable outcomes in patients experiencing acute stroke is essential for formulating tailored interventions to enhance patient prognosis. Objective: The primary objective of this study is the discovery of predictors of mortality and unfavorable functional outcomes in patients with acute stroke admitted to a hospital. Study design: A retrospective study Place and Duration: This study was conducted in Al-Tibri Medical College and Hospital Karachi from February 2022 to February 2023 Methodology: In this study, an analysis of medical records was executed, encompassing 200 patients who were admitted to the hospital due to acute stroke. The primary outcome measures consisted of mortality during hospitalization and inadequate functional status at the time of discharge and at the 3-month post-admission follow-up. Logistic regression analyses were carried out to discern the independent predictors associated with these outcomes. Results: Our analysis revealed that several factors were significantly associated with both unfavorable functional outcomes and mortality in patients suffering from acute stroke. These factors are age, NIHSS Score, comorbidities, hospital stay, and thrombolysis. Increasing age was associated with higher mortality rates and diminished functional status. A higher NIHSS score at admission was a predictor of worse outcomes. Patients with comorbid conditions such as hypertension, ischemic heart disease, diabetes mellitus, and various stroke subtypes were at increased risk for adverse outcomes. Prolonged hospitalization was related to a greater likelihood of unfavorable functional outcomes. Patients who did not receive intravenous thrombolysis exhibited a higher likelihood of experiencing unfavorable functional outcomes. Of the 200 patients diagnosed with acute stroke, a substantial portion, 28%, died during their hospital stay, while 61% demonstrated suboptimal functional outcomes at discharge, which increased to 73% at the 3-month follow-up. Conclusion: This investigation highlights multiple factors that serve as valuable predictors of adverse outcomes in patients having acute strokes admitted to the hospital. Early identification and management of modifiable risk factors, such as comorbidities and different types of stroke, could improve outcomes in this group of patients.