Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals

IF 2 4区医学 Q3 NEUROSCIENCES

Journal of Stroke & Cerebrovascular Diseases Pub Date : 2025-07-09 DOI:10.1016/j.jstrokecerebrovasdis.2025.108396

Miguel A. Vences , Miguel A. Barboza , Leonardo Augusto Carbonera , Virgilio E. Failoc-Rojas , Julieta Rosales , Pablo Amaya , Pablo Lavados

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引用次数: 0

Abstract

Background and Purpose

The Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals is a multicenter registry from various stroke centers in Latin America, exploring demographic, clinical, imaging, and functional outcomes in acute ischemic stroke (AIS) patients, with the intention of determining case-fatality rates (in-hospital, 30 and 90 days follow up) and analyzing associated risk factors.

Methods

We conducted a retrospective cohort study using data from hospitalized AIS patients over 18 years of age, collected from 27 centers in 11 Latin American countries between January 1 and December 31, 2022. The effect size was estimated using the hazard ratio (HR) and 95 % confidence intervals (95 % CI) through Cox regression models to assess the association between time to 30-day fatality event and covariates.

Results

A total of 2,997 patients were included. The mean age was 68.7 years and 48.1 % were women. In-hospital case-fatality was 9.42 %, 277 patients (10.2 %) died within 30 days, and 90-day case-fatality was relatively close at 353 patients (13.3 %). Complications were reported in 31.3 % of cases, most frequently infections (18.5 %). Age over 75 years (HRa=2.28), hyperglycemia (HRa=1.28), baseline status (HRa=1.61), stroke severity according to NIHSS >26 (HRa=6.11) and the presence of neurological complications (HRa=3.2) were risk factors for 30-day follow up case-fatality in these patients.

Conclusion

AIS patients in Latin America stroke centers had an in-hospital case-fatality of 9.42 % and the 30-day case-fatality was 10.2 %. Older age, hyperglycemia, baseline status, stroke severity and neurological complications were the strongest predictors of early case-fatality. The findings underscore the need to optimize stroke management protocols in the region.

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拉丁美洲医院卒中科室急性缺血性卒中病死率。

背景和目的：拉丁美洲医院卒中单位急性缺血性卒中病死率是一个来自拉丁美洲各卒中中心的多中心登记，探索急性缺血性卒中（AIS）患者的人口统计学、临床、影像学和功能结局，目的是确定病死率（住院、30天和90天随访）并分析相关危险因素。方法：我们进行了一项回顾性队列研究，使用了2022年1月1日至12月31日期间从11个拉丁美洲国家的27个中心收集的18岁以上住院AIS患者的数据。通过Cox回归模型使用风险比（HR）和95%置信区间（95% CI）估计效应大小，以评估时间至30天死亡事件与协变量之间的关联。结果：共纳入2997例患者。平均年龄为68.7岁，女性占48.1%。住院病死率为9.42%，30天内死亡277例（10.2%），90天病死率相对接近，为353例（13.3%）。并发症发生率为31.3%，感染发生率最高（18.5%）。年龄超过75岁（HRa=2.28）、高血糖（HRa=1.28）、基线状态（HRa=1.61）、NIHSS bbb26脑卒中严重程度（HRa=6.11）和存在神经系统并发症（HRa=3.2）是这些患者随访30天病死率的危险因素。结论：拉丁美洲卒中中心AIS患者住院病死率为9.42%，30天病死率为10.2%。年龄、高血糖、基线状态、中风严重程度和神经系统并发症是早期病死率的最强预测因子。研究结果强调了优化该地区脑卒中管理方案的必要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Stroke & Cerebrovascular Diseases Medicine-Surgery

CiteScore

5.00

自引率

4.00%

发文量

583

审稿时长

62 days

期刊介绍： The Journal of Stroke & Cerebrovascular Diseases publishes original papers on basic and clinical science related to the fields of stroke and cerebrovascular diseases. The Journal also features review articles, controversies, methods and technical notes, selected case reports and other original articles of special nature. Its editorial mission is to focus on prevention and repair of cerebrovascular disease. Clinical papers emphasize medical and surgical aspects of stroke, clinical trials and design, epidemiology, stroke care delivery systems and outcomes, imaging sciences and rehabilitation of stroke. The Journal will be of special interest to specialists involved in caring for patients with cerebrovascular disease, including neurologists, neurosurgeons and cardiologists.