Hospitalized Stroke Patients Research Articles

A Successful Quality Improvement Project for Detection and Management of Acute Stroke in Hospitalized Patients.

The incidence rate of stroke in hospitalized patients ranges between 2% and 17% of all strokes-a higher rate than in the community. Delays in recognition and management of stroke in hospitalized patients lead to worse outcomes. At our hospital, the existing in-hospital stroke (IHS) code showed low usage and effectiveness. In a quality improvement (QI) project, we aimed to improve the identification of and the quality of care for inpatient strokes. A nurse-driven IHS protocol was implemented, which alerted a specialized stroke team and cleared the computed tomography (CT) scanner. The protocol focused on prioritizing staff education, simplifying the process, empowering staff to activate an IHS code, ensuring adequate support and teamwork, identifying well-defined quality metrics (eg, time to CT and documentation tool use), and providing feedback communication. We analyzed 2 years of postimplementation IHS data for impact on stroke detection and outcomes. In the 2 years post QI, there was a more than 10-fold increase in IHS (pre-QI, n = 8; first year post QI, n = 94; second year post QI, n = 123). In the post-QI cohort, after excluding patients with missing information (n = 26), 69 cases had new stroke diagnoses (63 ischemic, 6 hemorrhagic), and 148 were stroke mimics. The mean (SD) time from IHS to CT was 18.7 (7.0) minutes. Of the 63 new ischemic stroke cases, 25 (39.7%) were treated with thrombolytic therapy and/or mechanical thrombectomy. The new IHS protocol has led to a marked increase in cases identified, rapid evaluation, and high utilization rate of acute stroke therapies.

Assessment instruments used for the self-report of pain by hospitalized stroke patients with communication problems: a scoping review protocol.

The objective of this scoping review is to systematically identify assessment instruments that are used for the self-report of pain by hospitalized stroke patients with communication problems. To the best of the authors' knowledge, there are no existing instruments specifically dedicated to measuring pain in stroke patients with communication problems. Pain measurement instruments currently in use may complicate pain assessment in these patients. Additionally, there is a lack of consensus regarding these patients' ability to self-report pain using existing pain instruments. The review will consider studies that focus on hospitalized adults where at least one subgroup has been diagnosed with stroke as well as associated communication problems attributable to a stroke. The concept of interest is assessment instruments used for the self-report of pain by these patients. The scoping review will include systematic reviews, quantitative studies of any design, and mixed methods studies. The search will occur in three phases: an initial limited search, a full search, and a screening of the reference lists of all the included articles. The key information sources include: PubMed, CINAHL, Nursing@Ovid, the Cochrane Library, Web of Science, Scopus, and Embase. All identified citations will be uploaded to a reference management program, and the titles and abstracts screened. Full texts of studies potentially meeting the inclusion criteria will be assessed in detail, with relevant data extracted and reported in tabular as well as descriptive format that aligns with the objectives and scope of this review.

Stratification of venous thromboembolism risk in stroke patients by Caprini score.

Venous thromboembolism (VTE) includes deep vein thrombosis (DVT) and pulmonary embolus (PE) is a serious complication in hospitalized stroke patients. This study is designed to examine the incidence of VTE and the effectiveness of chemo thromboprophylaxis in this population. From January 2015 to April 2018, we calculate the Caprini score for every admitted patient to evaluate VTE risk. For analysis Demographic information, Caprini score, national institutes of health stroke scale (NIHSS) score, prothrombin time (PT), thrombin time (TT), D-Dimer and medical co-morbidity are noted. Of 3,824 inpatients during the study period, 21 patients (0.55%) have VTE complications. Among patients (n=148) with a Caprini score between 0 and 2, 1 patient (0.68%) have VTE. VTE (52.38%) most commonly occurred in patients of Caprini score 7-8 group. In patients with VTE (n=21) age, Caprini score, NIHSS score, National Early Warning Score (NEWS) score, PT, TT, D-Dimer are significantly higher than those (n=3,803) without VTE (P<0.05). The Caprini score is highly recommended to assess the risk of venous thrombosis in stroke patients. Early mechanical and chemical prophylaxis are recommended for patients to reduce the incidence of venous thrombosis.

Patent Foramen Ovale Closure in hospitalized stroke patients in the United: Is there a racial disparity?

Background Racial disparity in stroke is well documented. Whether such disparity exists in the frequency of Patent Foramen Ovale (PFO) closure among patients with ischemic stroke (IS) is unclear. Objective To investigate the rate, trends, and racial determinants of PFO closure among hospitalized patients with ischemic stroke in the U.S. Methods The Nationwide Inpatient Sample was queried from 2006 to 2014 for patients older than 18-years of age with a primary discharge diagnosis of IS excluding those with a secondary discharge diagnosis of congenital heart diseases other than PFO. Patients were categorized by their PFO closure status. First, we determined the rate and 9-year trend in the rate of PFO closure. We then performed a logistic regression analysis to study the independent association between race and PFO closure. Results We identified a total of 1,028,565 patients with a primary discharge diagnosis of ischemic stroke, of whom 384 had PFO closure. In univariate analysis, PFO closure was more likely to be performed in younger patients, Hispanic patients, privately insured patients, those seen in large bed size academic center, and in patients in the high-income categories. We also observed that the rate of PFO closure decreased overtime overall and in all races, particularly after 2010. In multivariable logistic regression, Non-Hispanic Blacks were less likely to have PFO closure (OR: 0.51, 95%, CI: 0.35-0.74) when compared to Non- Hispanic Whites meanwhile the high rate of PFO closure in Hispanics observed in the univariate model was attenuated and did not reach statistical significance (OR: 1.57, CI: 0.90-2.72). Conclusions Although the rate of PFO closure has declined over time across all races after 2010, overall, Non-Hispanic Blacks were two times less likely to have a PFO closure after ischemic stroke than Non-Hispanic Whites after adjusting for demographic and socio-economic factors.

TO ESTIMATE THE INCIDENCE OF POTENTIAL DRUG-DRUG INTERACTION IN STROKE PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, TELANGANA

Objective: To determine the frequency and pattern of potential drug-drug interactions in hospitalized stroke patients.&#x0D; Methods: A retrospective study was carried out among patients treated for ischemic and haemorrhagic stroke at a tertiary care hospital, Hyderabad for a period of 1 y. A total of 177 prescriptions were analyzed during the study period. The potential drug-drug interactions were identified using Clinirex software.&#x0D; Results: Among the 177 prescriptions, 63.8% were male and 36.2% were female. Out of 177, 79 % of prescriptions had shown potential drug-drug interactions. The patients prescribed with more than 5 drugs developed higher incidence of drug-drug interactions. Based on severity scale we observed 12% major, 71% moderate and 17% minor drug-drug interactions. The incidence of pharmacodynamic interactions was 68% and the pharmacokinetic interactions were 32%.&#x0D; Conclusion: This study suggests that patients with stroke are frequently exposed to potential drug-drug interactions. The incidence of potential drug-drug interactions was higher in patients above 40 y. Most of the prescriptions contained polypharmacy which may lead to increased risk of hospitalization and higher health care cost. It is essential to identify potential drug-drug interactions especially in elderly patients as early as possible in order to prevent adverse drug reactions and ensure patient’s safety.

Risk factors of falls among hospitalized stroke patients

To explore the risk factors of falls among stroke patient within hospitalized. A quantitative descriptive design was adopted in this study. There were 48 stroke patients selected using consecutive sampling method. According to the scoring of risk factors of falls, patients were categorized into three levels, namely not risk (10.4%), low risk (33.3%), and high risk (56.2%). This result revealed that dominant patients had a high risk of falls. Risk factors of falls among inpatient of stroke patients were remains high. Therefore, imperative to identify the risk of falls using screening tools and to provide nursing intervention to prevent the incidence of falls among stroke patient during hospitalized.

Abstract TP29: Endovascular Thrombectomy in In-Hospital Stroke Patients

Background and Purpose: Outcome of in-hospital stroke (IHS) patients is reported to be poor because of having other diseases as malignancy, cardiac, kidney and pulmonary diseases. IHS accounts for 5% of all ischemic strokes. Recent endovascular thrombectomy (EVT) can dramatically improve the clinical outcome of acute large artery occlusion(LVO) patients. However, it is not clear whether EVT can improve the outcome of HIS patients with LVO. Methods: Our prospective stroke registry between 2014 and 2019 were retrospectively reviewed. Among them, we enrolled acute stroke patients with LVO treated with EVT. We classified two group; IHS group; had IHS patients and outside hospital onset stroke (OHS) group; stroke onset was outside of our hospital and were directly admitted to our hospital. We compared clinical background and patient outcome at 3 months between two groups. Favorable outcome was identified as mRS 0-2 at 3 months. Results: Among 225 EVT patients((age 79 years [68-83], male 140 [62%], NIHSS score 15 [8-21]), 27 and 198 patients were classified to the IHS group and OHS group, respectively. Age, gender, initial NIHSS score was similar between IHS and OHS group (P=0.891, 1.000, and 0.146). ICA occlusion tended to be infrequent in the IHS group (11% vs. 26%, P=0.098), while distal MCA occlusion tended to be frequent (41% vs. 25%, P=0.107). Successful reperfusion was achieved in 82% in the IHS group and in 84% in the OHS group (P=0.780). Favorable outcome at 3 months was similar between two groups (39% in the IHS group and 51% in the OHS group, P=0.457). Conclusion: Patient outcome at 3 months in IHS patients with LVO was similar to OHS patients. In hospital stroke patients with LVO, EVT should improve the patient outcome as well as OHS patients. Thus, EVT in HIS patients with LVO should be performed without hesitation.

Predictive accuracy of the Post-Stroke Depression Prediction Scale: A prospective binational observational study✰

BackgroundDepression after a stroke is a common complication that negatively influences stroke rehabilitation. Early identification, followed by adequate treatment of depression, improves recovery from stroke. To support early identification, the Post-stroke Depression Prediction Scale (DePreS) was developed to predict in the first week after stroke, the risk of depression in the second month. In this study we investigate the predictive accuracy of the DePreS in stroke patients. MethodsIn this prospective multicenter observational study, hospitalized stroke patients were included from three stroke units in the Netherlands and Germany using consecutive sampling. In the first week after stroke, the predicted risk for depression was estimated with the DePreS. Two months after stroke, major depressive disorder was determined with the Composite International Diagnostic Interview. ResultsOf the 93 included patients, 17 (18.3%) showed symptoms of major depressive disorder. With a cut-off value of ≥ 0, DePreS performed optimally with a sensitivity of 0.65 (95% CI 0.42–0.87), specificity of 0.74 (95% CI 0.64–0.84), positive predictive value of 0.35 (95% CI 0.19–0.52), and negative predictive value of 0.90 (95% CI 0.80–1.00). The AUC was 0.71 (95% CI 0.56–0.86). LimitationsThe generalizability of the study findings is limited to patients able to communicate adequately. ConclusionsThis study demonstrates that the DePreS is an adequate instrument for early and reliable identification of stroke patients who are not at risk of MDD in the second months after stroke. This limits the need for structural diagnostic follow-up to patients with a high risk.

A Comparative Study of Two Tube Feeding Methods in Patients with Dysphagia After Stroke: A Randomized Controlled Trial

Background: Dysphagia is a common symptom seen in stroke patients, it not only affects patients' nutrition supply, but also causes aspiration pneumonia. To solve the problem of nutritional support for patients with dysphagia after stroke, nasogastric tubes are routinely indwelling to provide nutrition in China. However, this feeding method sometimes causes food reflux, aspiration, pneumonia, and often affects the patients’ comfort and self-image acceptance. Aim: The aim of this study was to determine whether a new feeding method called intermittent oroesophageal (IOE) tube feeding compared with continuous nasogastric tube feeding as a practical and beneficial mean of decreasing the rate of stroke associated pneumonia (SAP), and improving patients’ swallowing function, comfort, psychological status. Design: This was an assessor-blinded, single-center, randomized controlled trial. Methods: Ninety-seven hospitalized stroke patients with dysphagia in the rehabilitation department from January to December 2018 were randomized to a control group and an intervention group. Patients in both groups received routine nursing, rehabilitation treatment and swallowing therapy. Patients in the intervention group were given IOE tube feeding, while those in the control group were fed by indwelling nasogastric tube. Outcomes were assessed at admission, discharge or the end of the tube feeding. Results: The incidence of SAP in the intervention group was 16.33% lower than that (31.25%) in the control group; the comfort score (2.08 ± .64), anxiety score (10.98 ± 2.28), depression score (7.39 ± 2.16) were lower than those (3.02 ± .70), (12.10 ± 2.18), (8.42 ± 2.34) in the control group. The improvement rate of swallowing function in the intervention group was 83.67% higher than that (66.67%) in the control group (all P < .05). Conclusions: The IOE tube feeding compared with continuous tube feeding may reduce the incidence of SAP, and improve patients’ swallowing function, comfort, psychological status in patients with dysphagia after stroke.

Study of serum uric acid level among stroke patients in a tertiary care hospital

Study of serum uric acid level among stroke patients in a tertiary care hospital

Intravenous thrombolytic therapy experience for ischemic stroke patients in a secondary care hospital

Intravenous thrombolytic therapy experience for ischemic stroke patients in a secondary care hospital

Influence of a Comorbid Diagnosis of Seizure on 30-Day Readmission Rates Following Hospitalization for an Index Stroke

To examine the association of a comorbid seizure diagnosis with early hospital readmission rates following an index hospitalization for stroke in the United States. Retrospective analysis of the 2014 National Readmission Database. The study population included adult patients (age >18 years old) with stroke, identified using the International Classification of Disease Ninth Revision, Clinical Modification (ICD-9-CM) codes 433.X1, 434.X1, and 436 for ischemic stroke as well as 430, 431, 432.0, 432.1, and 432.9 for hemorrhagic stroke. A subgroup of patients with a secondary discharge diagnosis of seizures was identified using the ICD-9-CM codes 780.39 and 345.X. We computed all-cause 30-day readmission rates for all strokes and by stroke type (ischemic versus hemorrhagic). Finally, we used a multivariable logistic regression model to examine the independent association between seizure and readmission by stroke type. Of 271,148 stroke patients, 6.3% (16,970) had a secondary discharge diagnosis of seizures including 5.0% (11,562) of patients with ischemic stroke and 13.4% (5,409) with hemorrhagic stroke. Overall readmission rate for stroke patients was 11.9% (hemorrhagic stroke: 14.2% versus ischemic strokes: 11.6%). Thirty-day readmission rate was higher in patients with seizures for all strokes (15.6% versus 11.7%, P value <.001), ischemic strokes (15.0% versus11.4%, P value <.001), and hemorrhagic strokes (16.7% versus 13.8%, P value <.001). After adjusting for several patient-specific and healthcare system-specific confounders, hospitalized stroke patients with comorbid seizure diagnosis were more likely than those without seizures to be readmitted within 30 days (OR: 1.20, 95% CI: 1.14-1.25). The presence of a comorbid diagnosis of seizure disorder in a hospitalized stroke patient significantly raises the occurrence of early hospital readmission in the United States.

Is paroxysmal supraventricular tachycardia truly benign? Insightful association between PSVT and stroke from a National Inpatient Database Study.

Atrial fibrillation and flutter are well-known causes of stroke. Whether other atrial arrhythmias categorized as paroxysmal supraventricular tachycardia (PSVT) are associated with stroke is less clear. We aimed to evaluate the association of PSVT with ischemic and embolic stroke and its impact on short-term outcomes in hospitalized stroke patients. National Inpatient Sample database of the USA was used to assess the association of PSVT with ischemic stroke. Atrial fibrillation and flutter were excluded to minimize the confounding effects. The association of PSVT with stroke was evaluated using univariate and multivariate analysis. Subgroup analyses by gender, age, and stroke type were also performed. PSVT was associated with increased odds of overall ischemic stroke in univariate [OR 1.18 (95% CI 1.09-1.27) p < 0.001] analysis. No such association was observed in multivariate analysis (OR 1.06 (95% CI 0.98-1.14) p = 0.1) or with subgroup analysis by gender and age. However, PSVT was associated with embolic stroke in both univariate (OR 2.01 (95%CI 1.67-2.43, p < 0.001) and multivariate analysis (OR 1.7 (95%CI 1.4-2.14) p < 0.001) as well as in subgroup analyses by gender and age. Furthermore, the presence of PSVT was associated with increased mortality in embolic stroke (OR 4.11, CI 2.29 to 7.39, p < 0.001) and increased total hospital cost and length of hospital stay in all stroke types. PSVT is independently associated with higher prevalence of embolic stroke but not with overall ischemic stroke. Patients with embolic stroke in the presence of PSVT have worse in-hospital outcomes with increased mortality.

Scoring Of Post Stroke Pneumonia In Uttaradit Hospital.

BackgroundStroke is a disease which occurs when the blood supply to the brain is interrupted, depriving brain tissue of oxygen, resulting in cell death. The symptoms of stroke include: numbness, paraplegia, dysarthria, ataxia, etc. The most common complication is infection. The highest death rates among hospitalized stroke patients are from pneumonia.ObjectiveTo develop a score for predicting post-stroke pneumonia infection and identify risk factors for patients with post-stroke pneumonia.Study designRetrospective case-control.SettingUttaradit hospital (the tertiary hospital), Thailand.MethodA retrospective data study was conducted at Uttaradit hospital, Thailand from January 2014 to October 2018 in which all of the subjects were diagnosed with either stroke with pneumonia or without pneumonia by a physician. The selected 324 stroke patients were divided into two groups: 108 patients were stroke with pneumonia and 216 patients were stroke without pneumonia. This study involved data collection and analysis of study characteristics to develop a predictive score for post-stroke pneumonia.ResultsThis study identified risk factors and developed a score for predicting post-stroke pneumonia infection by using significant covariates (duration of admission; 1–10 days=0 points, 11–20 days=1 point, more than 20 days=2.5 points, Cardiovascular disease=1.5 points, Nasogastric tube=2 points, Urinary tract infection=1 point). This score was interpreted to three groups; low risk (<2 points), moderate risk (2.5–4 points), and high risk (>4 points). Sensitivity was 80.56% and specificity was 93.52%.ConclusionA simple prediction tool was developed that uses only four clinical variables to predict risk of post-stroke pneumonia with high sensitivity and specificity.

Perfil de pacientes com sequelas de acidente vascular cerebral internados em um centro de reabilitação

O acidente vascular cerebral (AVC) causa um impacto negativo nos indivíduos afetados e ocasiona alto número de mortes e internações no mundo. O AVC causa incapacidades funcionais, e a reabilitação na fase aguda ajuda a reduzir instalação de complicações secundárias e favorecer a independência. A medida de independência funcional (MIF) é um instrumento amplo para mensurar a capacidade funcional nesta fase de reabilitação. O Objetivo: Avaliar o perfil sociodemográfico, clínico e funcional de indivíduos com AVC internados em um centro de reabilitação em Goiânia - GO. Método: O estudo foi transversal, analisou o prontuário de pacientes internados de julho de 2016 a julho de 2018, foi coletado o perfil sociodemográfico e a MIF no primeiro dia de internação. Resultados: Foram analisadas 138 fichas, houve predominância do sexo masculino, mediana de idade de 61 anos, 70,3% tiveram AVC isquêmico, 89,9% apresentaram hemiplegia, 46,4% o lado esquerdo foi mais acometido, 84,1% utilizavam cadeiras de rodas. 51,4% eram casados, 36,2% tinham baixa escolaridade e 60,1% eram hipertensos e 55 de mediana da MIF destacando maior independência funcional nos cuidados pessoais, controle, esfincteriano e conhecimento social. Concluisão: O perfil dos pacientes com AVC internados foi caracterizado por indivíduos do sexo masculino, baixa escolaridade e renda, idade avançada, altos índices de incapacidade funcional, alterações na marcha, espasticidade, hemiplegia e disfagia. Conhecer o perfil dos indivíduos com AVC ajudará a compreender suas causas e guiar políticas de prevenção, permitindo melhor qualidade de vida, rápida recuperação e reinserção às atividades de vida diária e à vida profissional.

122 Are We Effective Prescribers? A Retrospective Audit of DOAC Prescribing Post Embolic Stroke for Non Valvular Atrial Fibrillation

Abstract Background Direct oral anticoagulants (DOAC) are indicated for stroke prophylaxis in non-valvular atrial fibrillation, which is responsible for up to 20% of all ischaemic strokes(1). We performed a retrospective audit of all consecutive stroke patients in an Irish teaching hospital over a 1-year period to investigate the rate of incorrect dosing and any risk factors for this occurring. Methods We assessed our hospital stroke database from January to December 2017. Our research focused on DOAC prescribing in non valvular atrial fibrillation post embolic stroke. We collected data on baseline characteristics, choice of anticoagulation, dosing, and assessment of renal function, with follow up renal function if available. We reviewed electronic discharge summaries, online laboratory systems and completed a chart review. Results There was a total of 116 people with atrial fibrillation who developed an embolic stroke in our centre, of which 68 were eligible for anticoagulation using a DOAC (59). The main reasons for omission were CKD and haemorrhagic transformation. Patients were discharged on either Apixaban (32 patients), Rivaroxoban (32 patients), or Dabigatran (4 patients). Following our review, we established that 54/68 (79%) of patients were correctly anticoagulated. Over 20% of patients were incorrectly dosed and there was a clear tendency to under-dose 13/14 (93%). There were significant differences between the correct and incorrect dosing groups, with the latter group of patients being older and more at risk of polypharmacy. Renal function did not differ significantly between the groups at discharge or follow up and none of the incorrectly dosed patients were on a concurrent anti platelet. Conclusion A significant number of patients prescribed DOAC in hospital were not appropriately anticoagulated (21%), a majority of which were under-dosed. The patients who were under-dosed were older and more likely to be on 5 or more medications.

Frequency of Homocysteinemia in Young Ischemic Stroke Patients and Its Relationship with the Early Outcome of a Stroke.

ObjectiveTo find out the frequency of hyperhomocysteinemia in young ischaemic stroke patients and its relationship with early morbidity and mortality.MethodsThis prospective study was conducted on young ischemic stroke patients in Pakistan Atomic Energy Commission General Hospital, Islamabad. Ischaemic stroke patients of age < 45 years were selected from both the outpatient and inpatient departments. A fasting venous blood sample was sent for analysis. Data was collected through a structured proforma and were analyzed using SPSS 24.0 (IBM Corp, Armonk, NY, US). The outcome was measured at discharge using the modified Rankin scale.ResultsThe mean age of the 71 patients in the study was 35.8 years. Overall, 36 (50.7%) cases had hyper-homocysteinemia. The frequency was significantly higher in males and in the age group 36-45 years (63.4%). Levels of homocysteine did not significantly affect the outcome at discharge.ConclusionHyperhomocysteinaemia, a modifiable risk factor for ischaemic stroke, was seen in about half of young stroke patients. The levels of homocysteine did not correlate with early stroke outcome.

Clinical characteristics and treatment outcomes among stroke patients hospitalized to Nekemte referral hospital, western Ethiopia

ObjectivesStroke is the brain equivalent of a heart attack. It is one of the most common causes of morbidity and mortality worldwide and is a prominent cause of death, disability and dementia in sub-Saharan Africa (SSA). Hence, the purpose of this study was to assess the clinical characteristics and treatment outcomes among hospitalized stroke patients at Nekemte referral hospital (NRH). Patients and methodsRetrospective cross sectional study design was conducted on randomly selected stroke patients admitted to medical wards of NRH from 2013 to 2017. ResultsAmong 364 patients included in the study, 208 (57.1%) were males and the mean age of the patients was 59.66 ± 13.4 years. Regarding types of stroke, 192 (52.7%) were diagnosed as having ischemic stroke. During admission 132 (36.3%) patients complained left side body weakness (hemiparesis) and the major risk factor identified was hypertension 230 (63.2%). Overall, 65.4% of patients had poor outcome while 34.6% of patients had good out comes (improved). Being illiterate /unable to read and write (AOR = 3.94, 95% CI: 1.31–11.76, P = 0.01), attending secondary school (AOR = 3.6, 95% CI: 1.4–9.17, P = 0.007) and length of hospital stay >5 days (AOR = 2, 95% CI: 1.04–3.86, P = 0.037) were independent predictors of poor treatment outcome. ConclusionAbout two third of the patients had poor treatment outcome. Educational status and mean length of hospital stays were independent predictors of poor treatment out-comes. An emergency care setup capable of early patient evaluation, identification and management of stroke complications is crucial to overcome early stroke related mortality.

To Study the Medicine Use Evaluation in Stroke Patients in Hospital

To Study the Medicine Use Evaluation in Stroke Patients in Hospital

Mortality and trends in stroke patients with seizures: A contemporary nationwide analysis

ObjectiveSeizures are frequent among stroke patients. The goal of this study was to provide updated trends in seizures prevalence and mortality among hospitalized stroke patients. MethodsData from the National Inpatient Sample was used to estimate trends in seizures prevalence among stroke patients as well as mortality by seizures status, between 2006 and 2014. We used a logistic regression model to examine the association between seizures and mortality, accounting for extraneous factors. ResultsOverall 372,957 patients (6%) stroke patients had a secondary diagnosis of seizures. We found 29% higher odds of in-hospital death among stroke patients with a secondary diagnosis of seizures. The prevalence of seizures was more than two times higher among patients with hemorrhagic stroke (11.4%) compared to those with ischemic strokes (4.8%). The prevalence of seizures among stroke patients was 6.6% and 6.2% for all strokes, 12.6% and 12% for hemorrhagic strokes, and 5.3% and 5% for ischemic strokes respectively in 2006 and 2014. Although there was a steady decline in both groups, mortality rate among hospitalized stroke patients with seizures was consistently higher than in those without seizures for all strokes, ischemic strokes, and hemorrhagic strokes. Compared to patients with ischemic stroke and seizures, mortality rate was higher among patients with hemorrhagic stroke and seizures. SignificanceSeizures were present in nearly one out of 15 patients hospitalized for stroke and were more frequent among those with hemorrhagic stroke. There was a decline in mortality among stroke patients during the study period, which remained significantly higher in patients with seizures than in patients without seizures, and in those with hemorrhagic stroke compared to those with ischemic stroke.