One-year mortality after acute stroke: a prospective cohort study from a comprehensive stroke care centre, Kerala, India. Issue 11 (28th November 2022)

• Record Type: Journal Article
• Authors: Nambiar, Vivek; Raj, Manu; Vasudevan, Damodaran; Bhaskaran, Renjitha; Sudevan, Remya
• Is Part Of: BMJ open. Volume 12:Issue 11(2022)
• Publication Date: 2022-11-28
• Subjects: Stroke -- EPIDEMIOLOGY -- STROKE MEDICINE; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2022-061258
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objectives: The primary objective was to report the 1-year all-cause mortality among patients with stroke. The secondary objectives were (1) to report the mortality stratified by type of stroke and sex and (2) to report predictors of 1-year mortality among patients with stroke. Design: A prospective cohort study. Setting: Institutional–stroke care unit of a tertiary care hospital Participants: Patients who were treated in the study institution during 2016–2020 for acute stroke and were followed up for a period of 1 year after stroke in the same institution. Main outcome measures: The main outcome measures were the mortality proportion of any stroke and first ever stroke cohorts at select time points, including in-hospital stay, along with 2 weeks, 2 months, 6 months and 1 year after index stroke. The secondary outcomes were (1) mortality proportions stratified by sex and type of stroke and (2) predictors of 1-year mortality for any stroke and first ever stroke. Results: We recruited a total of 1336 patients. The mean age of participants was 61.6 years (13.5 years). The mortality figures for 2 weeks, 2 months, 6 months and 12 months after discharge were 79 (5.9%), 88 (6.7%), 101 (7.6%) and 114 (8.5%), respectively, in the full cohort. The in-hospital mortality was 45 (3.4%). The adjusted analysis revealed 3 predictors for 1-year mortality after first ever stroke—age, pre-treatment National Institutes of Health Stroke Scale (NIHSS) score and Modified Rankin Scale (mRS) score at baseline. The same for the full cohort had only two predictors—age and pre-treatment NIHSS score. Conclusion: Mortality of stroke at 1-year follow-up in the study population is low in comparison to several studies published earlier. The predictors of 1-year mortality after stroke included age, NIHSS score at baseline and mRS score at baseline.