Determinants of In-Hospital Mortality After Acute Stroke: A Cross-Sectional Study at a Tertiary Care Centre, Peshawar, Pakistan
Main Article Content
Abstract
Objective
To determine the predictors of in-hospital mortality in patients admitted with acute stroke
Methodology
This was a cross-sectional study carried out at the Department of Medicine, Hayatabad Medical Complex, Peshawar, Pakistan, from 10.6.2023 to 31.12.2025. Patients of stroke, 18 years and above, with documented radiological evidence of stroke were included in the study. A total of 159 patients meeting the inclusion and exclusion criteria were enrolled. All patients underwent a thorough clinical assessment at the time of admission, including history (demographics, time of onset, comorbidities), examination [Glasgow Coma Scale (GCS), National Institutes of Health Stroke Scale (NIHSS)], and relevant investigations (neuroimaging and serum creatinine). The patients were assessed daily for the development of complications until discharge or death. All information was recorded on a pre-designed proforma.
Results
Overall, the in-hospital mortality was 11.9% (n=19). Most had an ischemic stroke (n = 119, 74.8%). Hypertension was the most common comorbidity (n = 106, 66.7%), and aspiration pneumonia was the most common complication (n = 68, 42.8%). A low GCS on admission independently predicted mortality in both univariate and multivariable analyses (AOR = 0.75, 95% CI: 0.562 – 1.000, p = 0.050). Although significant in univariate analysis, NIHSS, the presence of any complication, and aspiration pneumonia did not remain significant after adjustment for other risk factors.
Conclusion
Low GCS on admission was an independent risk factor for mortality in acute stroke. The development of aspiration pneumonia predicted mortality alone but did not remain significant after adjustment for other risk factors, including GCS.
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