Factors associated to mortality alter 30 days, in a group of patients with cerebro-vascular ischemic disease (stroke)

Abstract

Introduction: the cerebro-vascular isquemic disease (stroke) is characterized by its high mortality and recurrence rate.

Recognizing the factors associated to mortality during the first month post-ictus should improve the prognosis and therapeutic approach.

Objective: Determining the factors associated to early mortality (first 30 days post-ictus) in a Colombian population group.

Material and methods: prospective cohort study by means of a passive follow up (telephone), including patients older than 18 years with clinical and imaging diagnosis of acute cerebro-vascular isquemic disease (stroke). We measured biochemical and inflammatory markers. Glasgow and NIHSS scales were used to assess the consciousness status and the severity of the clinical picture.

Results: 311 patients with stroke were included, completing follow up in 205 (65.6%) of them. The survival probabilities were 85.8% (IC95%: 80.2%-89.9%), better for men, (91%; IC95%:84.0%-95.4%) compared to women (81%; IC95% 72.1%-87.5%). The main factors associated to early mortality were more the severity of the clinical picture, assessed by NIHSS (RR=1.12 ic 95%: 1.08-1.17), and high plasma levels of PCR (RR=1.09 IC 95%: 1.04-1.14) e IL-6 (RR=1.01 IC 95%: 1.00-1.02).

Conclusion: higher score in the NIHSS scale >14, is an independent risk factor for early mortality in patients with stroke. The age, gender and degree of inflammation may be associated with this outcome.