Case-Fatality and Disability of Patients with Stroke in Iran

Abstract

Background: Few studies have been conducted to assess case-fatality and disability of Iranian patients with stroke. This study was designed to collect morbidity and case-fatality data of hospitalized patients with stroke, in Isfahan, a large city in the central part of Iran. Methods: From 2006 to 2011, by utilization of overlapping sources (discharge diagnoses, attending physicians, and hospitalization wards), all hospitalized patients with possible strokes were enrolled in the study, and their hospital records were summarized by experienced personnel and reviewed by a neurologist with experience in stroke. Patients with stroke were followed by phone calls or visited their residential addresses and their 28th day functional status was checked by translated version of Modified Rankin Scale. Forms and methods were derived from the World Health Organization MONICA and STEPS projects. Results: 9487 patients with stroke were identified, mean age 68.98±13.63 years, and 48.3% were females. The in-hospital case-fatality rate was at 16.5% and 28th-day case-fatality rate was at 25.6%. The greatest case-fatality was among patients with intracerebral hemorrhage, and the least case-fatality was among patients with ischemic stroke. Case-fatality was greater among female and older patients, and those with a previous history of stroke. Among survivors, only 26.9% were functionally independent (Modified Rankin Scale<3) which was greatest among patients with subarachnoid hemorrhage and least among patients with intracerebral hemorrhage. None of the patients were admitted to specific stroke units, nor did they receive thrombolytic therapy.