In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia
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 s...
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doaj-2f2a755cfd874ff88771256ba1158c152020-11-25T00:22:41ZengMDPI AGInternational Journal of Environmental Research and Public Health1660-46012018-05-0115592710.3390/ijerph15050927ijerph15050927In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi ArabiaAdel A. Alhazzani0Ahmed A. Mahfouz1Ahmed Y. Abolyazid2Nabil J. Awadalla3Khaled Katramiz4Aesha Faraheen5Shamsun Nahar Khalil6Razia Aftab7Department of Internal Medicine, College of Medicine, King Khalid University, Abha 61421, Saudi ArabiaDepartment of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi ArabiaDepartment of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi ArabiaDepartment of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi ArabiaDepartment of Neurology Section, Aseer Central Hospital, Saudi Arabia, Abha 21411, Saudi ArabiaDepartment of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi ArabiaDepartment of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi ArabiaDepartment of Family and Community Medicine, College of Medicine, King Khalid University, P.O. Box 641, Abha 61421, Saudi ArabiaObjectives: 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.http://www.mdpi.com/1660-4601/15/5/927first-time strokein-hospital mortalitycase fatalitydeterminantsSaudi Arabia |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Adel A. Alhazzani Ahmed A. Mahfouz Ahmed Y. Abolyazid Nabil J. Awadalla Khaled Katramiz Aesha Faraheen Shamsun Nahar Khalil Razia Aftab |
spellingShingle |
Adel A. Alhazzani Ahmed A. Mahfouz Ahmed Y. Abolyazid Nabil J. Awadalla Khaled Katramiz Aesha Faraheen Shamsun Nahar Khalil Razia Aftab In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia International Journal of Environmental Research and Public Health first-time stroke in-hospital mortality case fatality determinants Saudi Arabia |
author_facet |
Adel A. Alhazzani Ahmed A. Mahfouz Ahmed Y. Abolyazid Nabil J. Awadalla Khaled Katramiz Aesha Faraheen Shamsun Nahar Khalil Razia Aftab |
author_sort |
Adel A. Alhazzani |
title |
In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia |
title_short |
In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia |
title_full |
In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia |
title_fullStr |
In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia |
title_full_unstemmed |
In Hospital Stroke Mortality: Rates and Determinants in Southwestern Saudi Arabia |
title_sort |
in hospital stroke mortality: rates and determinants in southwestern saudi arabia |
publisher |
MDPI AG |
series |
International Journal of Environmental Research and Public Health |
issn |
1660-4601 |
publishDate |
2018-05-01 |
description |
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. |
topic |
first-time stroke in-hospital mortality case fatality determinants Saudi Arabia |
url |
http://www.mdpi.com/1660-4601/15/5/927 |
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