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Identification of mortality-related predictive factors in hospitalized patients with acute ischemic stroke

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Cerebrovascular diseases include some of the most common and devastating disorders: Ischemic stroke, hemorrhagic stroke, and cerebrovascular anomalies such as intracranial aneurysms and arteriovenous malformations. Cerebral ischemia is caused by reduction in blood flow lasting longer than several seconds. Acute occlusion of an intracranial vessel causes reduction in blood flow to the brain region it supplies. The magnitude of flow reduction is a function of collateral blood flow and this depends on individual vascular anatomy and the site of occlusion. [4] Mortality after stroke is still high, with stroke ranked as the second most common single cause of death in the developed world after ischemic heart disease, or third if all neoplastic diseases are considered as a group. [5] Complications after ischemic stroke comprise medical and neurological complications. Neurological complications include brain edema, hemorrhagic transformation, seizures and epilepsy, recurrent stroke, and delirium. These complications are less frequent than medical complications but occur earlier in the course of stroke progression - within 48-72 h of stroke onset rather than within the first few weeks of stroke. Results from some studies have indicated that deaths within the first few days of stroke are usually the direct consequence of brain damage from neurological complications. Similarly, autopsy series of early stroke fatalities have indicated that death within the first few weeks after stroke is mainly attributable to the direct effects of stroke, such as brain edema with transtentorial herniation. In a study of neurological worsening during the acute phase of ischemic stroke in 1964 patients, 33.6% of patients deteriorated because of progressive stroke, 27.3% as a result of brain swelling, 11.3% owing to recurrent ischemic stroke, and 10.5% because of parenchymal hemorrhage. The remaining 17.3% deteriorated because of pyrexia, hyperglycemia, and hypertension, which are abnormal physiological variables or medical complications. [5] There is a need to initiate a systemic data collection on predictive factors of mortality due to stroke since at such a significant mortality rate, stroke consumes a major part of limited health resources in a developing country like India. [2] Few systemic evaluations are available for association of factors with in-hospital mortality in stroke patients in India. Thus, this study was planned to find out various predictors of in-hospital mortality. In this prospective study, we have evaluated the significance of time to presentation to the hospital, examination scales, blood parameters for in-hospital mortality.

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This page is a summary of: Identification of mortality-related predictive factors in hospitalized patients with ischemic stroke, Astrocyte, January 2015, Medknow,
DOI: 10.4103/2349-0977.161613.
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