Clinical and pharmacotherapeutic factors as survival and death predictors in hospitalized post-stroke patients

Abstract

Stroke is a neurological disease. High mortality and sequelae that cause physical or psychological disability demand greater efforts for adequate therapeutic management. The present study aimed to identify signs, symptoms, comorbidities, and therapeutic agents associated with decreased survival time and increased death risk in hospitalized stroke patients. Medical records of stroke patients hospitalized in 2016 at a Peruvian hospital were included. Post-stroke survival time was determined using the Kaplan-Meier method. A comparison of the mean survival time of ischemic and hemorrhagic stroke patients was carried out with the Mantel-Cox test. In addition, the death risk or hazard ratio (HR) was determined using Cox proportional hazards model. The mean survival time was 34.37 (95% CI, 31.89-36.85) and 16.96 (95% CI, 12.35-21.56) days in post-ischemic and hemorrhagic stroke patients, respectively. Dyspnea, peripheral edema, sensory disorder, diffuse cerebral edema and previous stroke are associated with a decrease in survival time. In addition, multivariate analysis revealed that chronic kidney failure (HR=11.98; 95% CI, 2.33-61.68; p=0,003), dyslipidemia (HR=5.19; 95% CI, 1.65-16.32; p=0.005), previous stroke (HR=1.51; 95% CI, 0.41-5.63; p=0.043), and use of antihemorrhagic (HR=1.12; 95% CI, 0.79-1.59; p=0.002) or antiepileptic drugs (HR=1.08; 95% CI, 0.70-1.68; p=0.016) could be considered as death predictors. Clinical and pharmacotherapeutic factors associated with a decrease in mean survival time and increased death risk in hospitalized stroke patients were identified. These factors should be an alarm sign to provide special and timely medical care that reduces the risk of death in patients.