Anemia and low cholesterol as potential risk factors In-hospital acute ischemic stroke case fatality

Abstract

Introduction: Stroke is the leading cause of death among neurological diseases and the second leading cause of death after cardiovascular disease both globally as well as in Colombia. Multiple predictors of in-hospital mortality have been described in this population and recognizing this can reduce stroke-related death. Methodology: A one-center, retrospective, cross-sectional study was carried out between August 1st 2018 and August 1st 2019. Inclusion criteria were patients with acute ischemic stroke, who have clinical and neuroimaging criteria meeting the definition of stroke according to the WHO. Quantitative variables were summarized as medians and interquartile ranges, and bivariate analysis was used to evaluate associations with in-hospital stroke case fatality after admission to the neurology service. Results: 402 stroke patients were included: the median age was 73.28 years (±14.53) and 50.5% were men. The most prevalent vascular risks factors were hypertension (70.90%), diabetes mellitus type 2 (24.13%) and previous stroke (20.90%). There were 13 (3.2%) fatalities. Mean time from admission to death was 11.38 days (±10.8). Lower hemoglobin, total serum cholesterol, LDL cholesterol and HDL cholesterol levels, internal carotid artery stenosis >50% (p<0.01) and acute cerebral infarction by NIHSS score (>20) (p<0.0001) showed statistical significance with in-hospital case fatality in patients. Conclusions: NIHSS score, hemoglobin level, and cholesterol (total, LDL, HDL) levels upon admission may be used by clinicians to make the appropriate early transfer decisions to facilities with the capacity to offer advanced in-hospital stroke care