Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

Journal：Neurological Research

Publication type: Original Contributions

IF(IF): 2.448

PMID: 33357098 Link To Pubmed Full text Download

Stroke is the main cause of mortality and long-term disability worldwide [1], especially in China, where stroke burden has substantially increased over the last 30 years, and approximately 70% of strokes are ischemic strokes [2]. Studies examining the predictors of in‐hospital mortality on early outcome of acute ischemic stroke are scant. Our objectives were: (i) to evaluate risk factors affecting in-hospital mortality in patients with acute ischemic stroke; (ii) to evaluate gender differences in the above risk factors; (iii) to evaluate risk factors for in-hospital mortality in patients with ＞6 h after symptom onset; and (iv) to evaluate risk factors for in-hospital mortality in patients with ≤6 h after symptom onset (with an additional independent variable: with or without IA/IV thrombolysis).

We analyzed data from included patients with acute ischemic stroke (MRS prior to current event: MRS≤1) enrolled in the CSCA. Exclusion criteria: (i) Patients with TIA or with intracerebral and subarachnoid hemorrhage were excluded from the present analysis since their prognosis differs significantly from ischemic stroke [3, 4]. Also, in‐hospital strokes were excluded. (ii) Current pregnancy or 6 weeks postpartum, Liver insufficiency or kidney insufficiency, History of bleeding or bleeding tendency. The following baseline characteristics were compared between patients in the two study groups (In-hospital mortality or Not): Age (Raw data or at intervals of ten years), Gender, Education Level, Average income of family, Behavioral history (Smoking, Drinking), Medical history (Hypertension, Diabetes mellitus, Dislipidemia, Atrial fib/flutter, Previous TIA, Previous myocardial infarction, PVD, Previous ischemic stroke), Other heart disease (except AF or MI), Cerebral hemorrhage, SAH, Carotid artery stenosis, Heart failure, Prosthetic Heart Valve, Sickle cell, Dementia, Mental disturbance, COPD, Healthy, admission NIH Stroke Scale and GCS, Medications prior to admission (Antiplatelet, Anticoagulation, Antihypertensive, Cholesterol-Reducer, Diabetic medication, Chinese patent drug), Symptom timeline (hours), Complications of Thrombolytic Therapy, hosptial-acquired pneumonia, deep vein thrombosis, low-density lipoprotein, Hemoglobin A1C, Fasting glucose, HCY, Serum creatinine, BUN, INR, Uric acid, BMI(Body Mass Index), Blood pressure (Raw data or mean arterial pressure), Stroke Rehabilitation. Poisson regression models were used to analyze predictors of in-hospital mortality, in which we included the predefined confounding factors as well as variables associated with P<0.15 or 0.2 in the univariate analyses. Two-sided probability values <0.05 were considered indicative of statistical significance.