Seyed Morteza Shamshirgaran
1,2*, Hamid Barzkar
2, Darioush Savadi-Oskouei
3, Mohammad Yazdchi Marandi
3, Abdolrasoul Safaiyan
1, Ehsan Sarbazi
1, Hossein Novbakht
1, Saber Gaffari
41 Epidemiology and Statistics Departement, Faculty of Health Sciences, Tabriz University of Medical Siences, Tabriz, Iran
2 Injury Epidemiology Prevention Research Centre, Tabriz University of Medical Siences, Tabriz, Iran
3 Neurosciences Research Centre, Imam Reza Hospital, Tabriz University of Medical Sciences, Tabriz, Iran
4 School of Nursing of Miandoab, Urmia University of Medical Sciences, Urmia, Iran
Abstract
Introduction: Stroke is one of the important causes of death and disability in Iran. This study aimed to examine the factors influencing the short-term mortality of stroke in Northwest of Iran.
Methods: Study population were all patients with confirming the diagnosis of the first-ever stroke who were hospitalized in two referral teaching hospitals from October 2013 to March 2015. They were followed up to 30 days after onset of stroke. A neurology year three resident was responsible for extracting the clinical data and assessment of stroke severity on admission using National Institute of Health Stroke Scale (NIHSS), and information about risk factors and socio-demographic factors were collected using face to face interview. Data were analysed using Cox proportional regression by STATA software version 14.
Results: A total of 1036 consecutive patients with first-ever stroke were included in this study. Of them, 228 patients (22%) died within 30 days after stroke accordance. Advanced age was significantly associated with a hazard for early mortality (HR=1.05 95% CI 1.09–1.04), the inverse was true for education level; mortality decreased as the education level increased; it was 25.7 percent among illiterate and 14.3 among patients with higher education. The NIHSS score on admission for 30-days mortality and hemorrhagic stroke were associated with HR=1.11 (95% CI 1.09–1.13) and HR= 1.65 (95% CI 1.15–2.36) respectively.
Conclusion: Advanced age, stroke subtype and high NIHSS score are the independent predictors of early mortality in this study. This provides important implications for the clinicians to target the high-risk patients for the specific therapies and management strategies.