Henrikas Kazlauskas, Elena Bovina, Geriuldas Žiliukas
Abstract
The aim of the study was to analyse the changes in inpatient mortality from acute stroke in the stroke unit of the Klaipeda University Hospital in 2007- 2015. Medical history data of 265 patients who died from acute stroke in the stroke unit were analysed. Inpatient mortality rate was calculated among all patients diagnosed with acute stroke who were treated in the stroke unit during the entire study period. The number of deaths in different age groups (up until 65; 65 and older) and comorbidities in patients who died from acute stroke were analysed, depending on stroke type in different treatment periods (2007-2011 and 2012-2015). The International Classification of Diseases, Tenth Revision (ICD-10), Codes I60-I64 were used to diagnose different stroke types in 2007-2011, while ICD-10 AM, Codes I60-I64 were used in 2012- 2015. The statistical analysis was performed using SPSS 17.0 for Windows. Chi-squared (χ2) criterion and Fisher’s exact test were used for small samples to evaluate dependency and homogeneity of qualitative characteristics. The difference between them was considered as statistically significant at p <0.05. Data are presented as a percentage. Student’s t-test was applied for average age comparison. Odds ratio (OR), reflecting the mortality from acute stroke in different periods, was established. The comparison of the two study periods revealed the decrease in patients who died from acute stroke – from 7.0% (2007-2011) to 4,3 % (2012-2015), (p<0.001). Mortality from ischemic and hemorrhagic stroke was similar. The analysis showed significant age difference (p=0.007) among patients who died from acute stroke: in the later study period (2012-2015), the patients were older than those who died in the earlier period; however, no significant difference was observed when analysing them by age groups (up until 65; 65 and older). The odds of dying in 2007- 2011 were 1.69 times higher than in 2012-2015 (p<0.001), whereas the odds ratio for ischemic stroke in 2007-2011 was 1.75 times higher than in 2012- 2015 (p<0.0001). No significant difference between different study periods was established when analysing the changes in the number of comorbidities in patients who died from acute stroke. The assesment of differences in comorbidities depending on the stroke type revealed that significantly more patients who died from ischemic stroke had been diagnosed with coronary heart disease (CHD) (including angina pectoris (AP) and atrial fibrillation (AF)) than those who died from hemorrhagic stroke. It was concluded that, when comparing the two study periods, the number of patients who died from acute stroke decreased significantly – from 7.0% (2007- 2011) to 4.3% (2012-2015) (p<0.001). The odds ratio for dying from acute stroke in 2007-2011 was established to be significantly higher than in 2012- 2015 and patients who died from acute stroke in the later study period were significantly older.
Keyword(s): acute stroke; inpatient mortality; changes.
DOI: 10.5200/sm-hs.2016.075
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