Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals

BACKGROUND AND PURPOSE: The Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals is a multicenter registry from various stroke centers in Latin America, exploring demographic, clinical, imaging, and functional outcomes in acute ischemic stroke (AIS) patients, with the i...

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Autores principales: Miguel A. Vences, Miguel A. Barboza, Leonardo Augusto Carbonera, Virgilio E. Failoc‐Rojas, Julieta Rosales, Pablo Amaya, Pablo M. Lavados, María Álvarez, Fernando Góngora‐Rivera, Verónica V. Olavarría, Pablo A. González, Celina Ciardi, Pedro Lylyk, Juan Cirio, Natalia Llanos‐Leyton, Julián Alejandro Rivillas, Donoband Melgarejo, Analia Cardozo, Lorena Gallardo-Peralta, Andrés Silva-Pozo, Liliana Rodríguez-Kadota, Diego Canales, Sara Lorena Salvador-Mateo, Sebastián León-Vallejo, Mariángel Gabriela Vásquez Zevallos, Angelica Ruiz Franco, Natalia Balián, Marianela Soledad Lopez Armaretti, María Victoria Acosta, Ronald Alexis Soto Arancibia, Felipe Romero, Luis José Cotes Mendoza, Andrés Eduardo Diaz Guzmán, Luis Roa, Laura Boada Robayo, Loren Marcela Gallo, F Carvajal, Esteban Montoya Vera, William Bayona Pancorbo, Carla Gabriela Román Ojeda, Jorge Emilio Alfonso, Violeta Celis, Rodrigo Décima Bonaglia, María I. Rodríguez, Ramiro Rocha Rodríguez, Gonzalo Pérez, Nelson Novarro, Diana Manrique-Otero, Ana María García Callejas, Jaime Eduardo Rodriguez Orozco, Carlos Fernando Martinez Rubio, Laura Andrea Serna Corredor, Fabiola Serrano, Claudia Vanessa Cano Nigenda, Alessandra Pompa, Gisele Sampaio Silva, Eva Rocha, J M Cruz
Formato: Artículo
Lenguaje:inglés
Publicado: 2025
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Sumario:BACKGROUND AND PURPOSE: The Case-fatality of acute ischemic stroke in stroke units of Latin American hospitals is a multicenter registry from various stroke centers in Latin America, exploring demographic, clinical, imaging, and functional outcomes in acute ischemic stroke (AIS) patients, with the intention of determining case-fatality rates (in-hospital, 30 and 90 days follow up) and analyzing associated risk factors. METHODS: We conducted a retrospective cohort study using data from hospitalized AIS patients over 18 years of age, collected from 27 centers in 11 Latin American countries between January 1 and December 31, 2022. The effect size was estimated using the hazard ratio (HR) and 95 % confidence intervals (95 % CI) through Cox regression models to assess the association between time to 30-day fatality event and covariates. RESULTS: A total of 2,997 patients were included. The mean age was 68.7 years and 48.1 % were women. In-hospital case-fatality was 9.42 %, 277 patients (10.2 %) died within 30 days, and 90-day case-fatality was relatively close at 353 patients (13.3 %). Complications were reported in 31.3 % of cases, most frequently infections (18.5 %). Age over 75 years (HRa=2.28), hyperglycemia (HRa=1.28), baseline status (HRa=1.61), stroke severity according to NIHSS >26 (HRa=6.11) and the presence of neurological complications (HRa=3.2) were risk factors for 30-day follow up case-fatality in these patients. CONCLUSION: AIS patients in Latin America stroke centers had an in-hospital case-fatality of 9.42 % and the 30-day case-fatality was 10.2 %. Older age, hyperglycemia, baseline status, stroke severity and neurological complications were the strongest predictors of early case-fatality. The findings underscore the need to optimize stroke management protocols in the region.