Risk Factors for In-Hospital Mortality among Ischemic Stroke Patients in Southern Taiwan

Ong, Cheung-Ter; Sung, Sheng-Feng; Wong, Yi-Sin; Wu, Chi-Shun; Hsu, Yung-Chu; Su, Yu-Hsiang; Li, Chen-Hsien; Hung, Ling-Chien

doi:10.1016/j.ijge.2014.06.013

Cited by 18 publications

(19 citation statements)

References 27 publications

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“…Grube and colleagues reported that persons aged ≥85 years were more likely to die after stroke compared with those aged <65 years (odds ratio [OR]; 13.50, 95% CI; 5.54–32.89) [ 26 ]. In our study, almost one in five (18.2%) of the cohort experienced in-hospital death, which was higher compared to that reported among cohorts of older adults in Italy (10.9%) [ 14 ], China (3.1%) [ 30 ], Saudi Arabia (11.0%) [ 31 ], and Canada (13.4%) [ 32 ], although a recent study reported a much higher (35.7%) in-hospital stroke death rate in Turkey [ 33 ]. The differences were likely to be due to a myriad of factors, including study design, disease definition, local factors (e.g., the standard of hospital care or treatment received), but particularly due to the fact that, in the other studies, all patients had ischaemic stroke, for which the case fatality was significantly lower than for haemorrhagic stroke [ 34 ].…”

Section: Discussioncontrasting

confidence: 73%

Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

Ofori‐Asenso

Zomer

Chin

et al. 2018

IJERPH

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The burden of comorbidity among stroke patients is high. The aim of this study was to examine the effect of comorbidity on the length of stay (LOS), costs, and mortality among older adults hospitalised for acute stroke. Among 776 older adults (mean age 80.1 ± 8.3 years; 46.7% female) hospitalised for acute stroke during July 2013 to December 2015 at a tertiary hospital in Melbourne, Australia, we collected data on LOS, costs, and discharge outcomes. Comorbidity was assessed via the Charlson Comorbidity Index (CCI), where a CCI score of 0–1 was considered low and a CCI ≥ 2 was high. Negative binomial regression and quantile regression were applied to examine the association between CCI and LOS and cost, respectively. Survival was evaluated with the Kaplan–Meier and Cox regression analyses. The median LOS was 1.1 days longer for patients with high CCI than for those with low CCI. In-hospital mortality rate was 18.2% (22.1% for high CCI versus 11.8% for low CCI, p < 0.0001). After controlling for confounders, high CCI was associated with longer LOS (incidence rate ratio [IRR]; 1.35, p < 0.0001) and increased likelihood of in-hospital death (hazard ratio [HR]; 1.91, p = 0.003). The adjusted median, 25th, and 75th percentile costs were AUD$2483 (26.1%), AUD$1446 (28.1%), and AUD$3140 (27.9%) higher for patients with high CCI than for those with low CCI. Among older adults hospitalised for acute stroke, higher global comorbidity (CCI ≥ 2) was associated adverse clinical outcomes. Measures to better manage comorbidities should be considered as part of wider strategies towards mitigating the social and economic impacts of stroke.

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Section: Discussioncontrasting

confidence: 73%

Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

Ofori‐Asenso

Zomer

Chin

et al. 2018

IJERPH

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“…In the study of Cheung-Ter Ong et al, the average age of the dead was significantly higher than that of the living subjects, while in the present study, there was no significant difference between the mean age of the deceased and the living individuals. 8 In the study of Firouzabadi, the prevalence of mortality among patients with stroke was 17.1%, which was significantly correlated with age and similar to the present study, it was high in ischemic type. 10 In the study of Yuan MZ and et al in 2017, 56% of patients were over 75 years of age and the mortality rate of patients was direct relation with age.…”

Section: Discussionsupporting

confidence: 89%

“…7 In another study by Cheung-Ter Ong et al in 2014 , 2556 patients with ischemic stroke showed that 58% of the patients were male and the mean age of patients was 69.5 years, which was higher than the current study. 8 The results of a 5 year mortality study in patients aged 15-49 years with the first ischemic stroke showed that the mean age of patients was 41.5±7.4 and 62.8% were male. 9 In Firozabadi and et al study on 1219 patients with stroke, the mean age of patients was 69.6 years which was higher than the current study.…”

Section: Discussionmentioning

confidence: 99%

Frequency and causes of mortality in patients with stroke referred to Zahedan city hospital in 2016

2018

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Background: Stroke is the fifth common cause of mortality worldwide. This study was conducted with the aim of Evaluation of mortality rate and its causes in patients with stroke referred to Zahedan city hospital.Methods: This was a cross-sectional study that conducted on 320 patients with stroke. Data collected by a checklist and then analyzed by statistical methods in SPSS.19.Results: Of all patients, 59.7% were male and 40.3% were female. The mean age of patients was 63.18±13.85 years. 76% of the strokes were ischemic and 24% were hemorrhagic. The mortality rate in this study was 16.3% which was not correlated with age, gender and type of stroke. The most common cause of mortality was pneumonia aspiration with 36.5 % and then sepsis with 32.7%.Conclusions: In overall, this study showed that mortality rate was 16.3 % and the most common cause of mortality was pneumonia aspiration and sepsis.

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“…In our study, the in-hospital mortality rate among the patients who suffered a stroke was 22.9%, and the deceased patients had a significantly higher CCI and ECI index. The rate of mortality caused by acute stroke was between 3% and 18% in Taiwan, 12.5% in Ethiopia, while in the United States every fourth patient died of the stroke ( 15 , 16 ).…”

Section: Discussionmentioning

confidence: 99%

Performance of Charlson and Elixhauser Comorbidity Index to Predict in-Hospital Mortality in Patients with Stroke in Sumadija and Western Serbia

Bajić¹,

Galic²,

Mihailović³

et al. 2021

ijph

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Background: Comorbidities are major predictors of in-hospital mortality in stroke patients. The Charlson comorbidity index (CCI) and the Elikhauser comorbidity index (ECI) are scoring systems for classifying comorbidities. We aimed to compare the performance of the CCI and ECI to predict in-hospital mortality in stroke patients. Methods: We included patients hospitalized for stroke in the Clinical Center of Kragujevac, Serbia for the last 7 years. Hospitalizations caused by stroke, were identified by the International Classification of Diseases-10 (ICD-10) codes I60.0 - I69.9. All patients were divided into two cohorts: Alive cohort (n=3297) and Mortality cohort (n=978). Results: There were significant associations between higher CCIS and increased risk of in-hospital mortality (HR = 1.07, 95% CI = 1.01–1.12) and between higher ECIS and increased risk of in-hospital mortality (HR = 1.04, 95% CI = 0.99–1.09). Almost 2/3 patients (66.9%) had comorbidities included in the CCI score and 1/3 patients (30.2%) had comorbidities included in the ECI score. The statistically significant higher CCI score (t = -3.88, df = 1017.96, P <0.01) and ECI score (t = -6.7, df = 1447.32, P <0.01) was in the mortality cohort. Area Under the Curve for ECI score was 0.606 and for CCI score was 0.549. Conclusion: Both, the CCI and the ECI can be used as scoring systems for classifying comorbidities in the administrative databases, but the model’s ECI Score had a better discriminative performance of in-hospital mortality in the stroke patients than the CCI Score model.

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Risk Factors for In-Hospital Mortality among Ischemic Stroke Patients in Southern Taiwan

Cited by 18 publications

References 27 publications

Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

Effect of Comorbidity Assessed by the Charlson Comorbidity Index on the Length of Stay, Costs and Mortality among Older Adults Hospitalised for Acute Stroke

Frequency and causes of mortality in patients with stroke referred to Zahedan city hospital in 2016

Performance of Charlson and Elixhauser Comorbidity Index to Predict in-Hospital Mortality in Patients with Stroke in Sumadija and Western Serbia

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