Predictors of in-hospital mortality and dependence at discharge in patients with MCA stroke with intravenous thrombolysis

AbstractEarly risk stratification of mortality and dependence is important for guiding medical decision-making in stroke care. The study aim is to evaluate whether there are any differences between risk factors for in-hospital mortality and dependence at discharge in patients with first-episode ischemic stroke in the middle cerebral artery (MCA) receiving intravenous thrombolysis (IVT) treatment. The study comprised a single-center cohort of patients admitted consecutively for first-episode MCA ischemic stroke. A logistic regression analysis was performed to determine the variables associated with in-hospital mortality and dependence at discharge. We included 169 patients (50.9% women) with a mean age of 64.1  ± 12.9 years and a median National Institute of Health Stroke Scale (NIHSS) score of 13 (range 3–26) at admission. Nineteen patients (11.2%) died as inpatients [the main cause of death was found to be infection (47.4%)]. The independent predictors for in-hospital mortality were: age (OR 1.09, 95% CI 1.03–1.15,p = 0.004) and NIHSS score (>17) at admission (OR 1.17, 95% CI 1.05 –1.30,p = 0.004). Two other crude models used to analyze in-hospital mortality (age and symptoms-to-needle time, and age and symptomatic intracerebral hemorrhage) were significant. NIHSS score (>11) at admission (OR 1.29, 95% CI 1.17 –1.42,p <  0.001) and large artery atherosclerosis stroke (OR 3.10, 95% CI 1.10–8.76,p = 0.031) were independently associated with depen...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research