Patient Demographics, Characteristics and Intrahospital Mortality of Different Ischemic Stroke Subtypes in a Tertiary Hospital During Five-Year Period

Sintija Strautmane; Kristaps Jurjāns; Estere Zeltiņa; Evija Miglāne; Andrejs Millers

doi:10.3390/IECMD2021-10315

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Patient Demographics, Characteristics and Intrahospital Mortality of Different Ischemic Stroke Subtypes in a Tertiary Hospital During Five-Year Period

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¹ Rīga Stradiņš University, Faculty of Residency, Dzirciema iela 16, Rīga, LV – 1007, LATVIA; Pauls Stradiņš Clinical University Hospital, Department of Neurology, Pilsoņu iela 13, Rīga, LV – 1002, LATVIA
² Rīga Stradiņš University, Department of Doctoral studies, Dzirciema 16, Rīga; The Red Cross Medical College of Rīga Stradiņš University, Jāņa Asara 5, Rīga; Pauls Stradiņš Clinical University Hospital, Department of Neurology, Pilsoņu 13, Rīga
³ Pauls Stradiņš Clinical University Hospital, Department of Neurology, Pilsoņu iela 13, Rīga, LV – 1002, LATVIA
⁴ Rīga Stradiņš University, Department of Neurology and Neurosurgery, Dzirciema iela 16, Rīga, LV – 1007, LATVIA; Pauls Stradiņš Clinical University Hospital, Department of Neurology, Pilsoņu iela 13, Rīga, LV – 1002, LATVIA

Academic Editor: Edgaras Stankevicius

Published: 21 June 2021 by MDPI in The 1st International Electronic Conference on Medicine session Neurology

https://doi.org/10.3390/IECMD2021-10315

Abstract:

Background and Objectives. Ischemic stroke (IS) is one of the leading causes of disability, morbidity, and mortality worldwide. The aim of this study was to evaluate patient demographics, characteristics and intrahospital mortality among patients with different IS subtypes.

Materials and Methods. An observational non-randomized study was conducted using IS patient data from a single center from 2016 to 2020 with the diagnosis of acute IS confirmed by head computed tomography (CT). The pathogenetic IS subtypes were determined using Causative Classification System for IS (CCSIS).

Results. There was a slight female predominance among our study population, as 2673 (56.2%) patients were females. In our study group, most common IS subtypes were cardioembolic stroke (CS), 2252 (47.4%), and atherothrombotic stroke (AS), 1304 (27.4%). CS patients were significantly more severely disabled on admission, 1828 (81.4%), and on discharge, 378 (16.8%), p<0.05. Moreover, patients with CS demonstrated the highest rate of comorbidities and risk factors (p<0.05). Differences between the total patient count with no atrial fibrillation (AF), paroxysmal AF, permanent AF and different IS subtypes among our study population demonstrated not only statistical significance, but also a strong association (Cramer’s V = 0.53). Majority of patients in our study group were treated conservatively, 3389 (71.3%). Reperfusion therapy was significantly more often performed among CS patients (n=770, 34.2%; p<0.05). The overall intrahospital mortality among our study population was 570 (12.0%) with the highest intrahospital mortality rate noted among CS patients (n=378, 66.3%; p<0.05). No statistically significant difference was observed between acute myocardial infarction and adiposity (p>0.05).

Conclusions. In our study, CS and AS were the most common IS subtypes. CS patients were significantly older with slight female predominance. CS patients demonstrated the greatest disability, risk factors, comorbidities, reperfusion therapy and intrahospital mortality.

Keywords: ischemic stroke; demographics; intrahospital mortality; cardioembolic stroke; atherothrombotic stroke; lacunar stroke; computed tomography; reperfusion therapy; conservative therapy

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