Factors Predicting In-Hospital Mortality in Ischemic Stroke Patients in Bogotá, Colombia
Stefanía Forero Caldas1, Annelise Pereira1, Juan Martinez Lemus1, Neiry Maria Zapa Pérez1, Mariana Medina1, Juana Navarro1, Andrea Ponguta1, Delia Giraldo1, Hernan Bayona1, Claudio Jiménez1
1Grupo de Investigación de Neuroepidemiología Clínica, Neurology Department, USS Simón Bolívar, Subred Integrada de Servicios de Salud Norte E.S.E.
Objective:
To determine the in-hospital predictors of mortality of ischemic stroke (IS) patients in a single institution in Bogota, Colombia.
Background:
Stroke is the second leading cause of death and the primary cause of disability worldwide. While risk factors for IS are well-documented in large cohorts from high-income countries, studies addressing predictive factors in middle and middle-upper income countries remain scarce.
Design/Methods:
Cross-sectional retrospective study including patients with acute IS admitted to the Neurohospitalist Department at a single institution in Bogotá, Colombia. Sociodemographic, clinical, and outcome variables were retrieved from electronic medical records from 2020 to 2022. Age- and sex-adjusted logistic regression analyses were performed using SPSS v25.
Results:
820 patients were included. Factors associated with higher in-hospital mortality from IS included a history of coronary artery disease (OR=2.57, CI95%:[1.63-4.03]), atrial fibrillation (OR=2.38, CI95%:[1.61-3.50]), type 2 diabetes (OR=1.79, CI95%:[1.18-2.71]), SARS-CoV-2 infection within the prior six months (OR=4.90, CI95%:[2.73-8.80]), moderate-severe stroke at admission (OR=5.97, CI95%:[3.03-11.74]), and large vessel occlusion (OR=2.34, CI95%:[1.45-3.75]). In-hospital complications such as hemorrhagic transformation (OR=2.44, CI95%:[1.30-4.56]), aspiration pneumonia (OR=8.99, CI95%:[4.92-16.44]) and tracheitis (OR=5.13, CI95%:[2.29-11.50]), along with procedures such as craniectomy (OR=4.59, CI95%:[1.36-15.42]), gastrostomy (OR=4.87 CI95%:[2.68-8.86]), and tracheostomy (OR=6.86 CI95%:[3.24-14.56]) were also associated with an increased mortality.
Conclusions:
In this study, the factors associated with acute IS mortality included prior cardiovascular diseases, complications related to the condition, and required ancillary invasive procedures. Policymakers and stroke centers in middle-upper income countries must focus on addressing these factors to improve stroke mortality outcomes.
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