Characteristics and Outcomes of Stroke Patients Admitted to the Medical Ward and the Intensive Care Unit of a Tertiary Hospital in Saudi Arabia

Abstract

Background: Stroke is a major source of morbidity and mortality worldwide. Patients with stroke are often managed in the medical ward. However patients with severe stroke, constituting a bout 15-20%, require admission into the Intensive Care Unit (ICU). Despite this, there are little data available on the characteristics and functional outcome of survivors amongst stroke patients admitted to the ICU and those admitted to the medical ward. Aim: to determine characteristics, functional outcomes of survivors and predictors of poor outcome in patients admitted to the medical ward and the ICU with a primary diagnosis of stroke at king Khalid Hospital in Hail, Saudi Arabia. Methods: We reviewed the medical records of all stroke patients admitted to the ICU and the medical ward between February 2010 and July 2016, at King Khalid Hospital in Hail. Demographic characteristics, clinical features and course, treatment options and outcome of all stroke patients were documented on pre-defined data sheets. Result: A total 1187 files of stroke patients were reviewed. The male to female ratio was 2:1 and patients aged >60 years accounted for 74.6%. Ninety percent of Stroke patients were admitted into the medical ward, while less than 10% were admitted to ICU. Stroke patients in the ICU had a mortality rate of 73.2%. While the mortality rate of patients admitted to the medical ward was 17.6%. Patients admitted into the ICU were 4 times more likely to die compared to stroke patients admitted to medical ward (p=0.002, OR=4.472). However, admission location had no significant impact on duration of patients' hospital stay (p=0.454, OR=1.464). Conclusion: Intensive care admission was found to be associated with a high mortality rate and a high likelihood of dependent lifestyle after hospital discharge. We suggest that clinicians critically examine the suitability of stroke patients requiring ICU admission in the light of these findings and other published data.