Predictors of In-Hospital Mortality Among Stroke Patients at a Tertiary Care Hospital in Nepal
A Prospective Cohort Study
Bibliographic Data
| ID | 13775460 |
|---|---|
| Authors | Saru Panthi (Pokhara University, corresponding author), Sabina Sankhi (0000-0002-7881-2864, Purbanchal University), Bibek Bhandari (0000-0002-2732-6508, Post Consultant Physician, Dhading Hospital, Dhading Nepal), Shishir Paudel (0000-0003-3077-6697, Pokhara University), Nirmal Raj Marasine (0000-0003-4353-382X, Pokhara University) |
| Year | 2025 |
| Volume | 62 |
| Pages | 469580251385397-469580251385397 |
| Publication date | 2025-09-01 |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | INQUIRY The Journal of Health Care Organization Provision and Financing (JOURNAL) |
| Journal identifiers | ISSN: 0046-9580 • E-ISSN: 1945-7243 |
| Publisher | SAGE Publishing (PUBLISHER • US) |
| DOI | 10.1177/00469580251385397 |
| PMID | 41174984 |
| OpenAlex | W4415762168 |
| Language | EN |
| References cited | 25 |
Stroke is a leading cause of morbidity and disability, with limited data on in-hospital mortality from low-resource settings. This study aimed to identify predictors of in-hospital mortality among stroke patients at a tertiary care hospital in Nepal. A prospective cohort study was conducted among 120 stroke patients aged ≥ 18 years, enrolled between November 2023 and April 2024. The primary outcome was in-hospital mortality following admission. Data was analysed using SAS version 9.4. Kaplan-Meier survival analysis and Cox proportional hazards regression were employed to identify predictors of in-hospital mortality. A p -value < .05 was considered statistically significant. The cohort comprised 68.3% ischemic and 31.7% haemorrhagic strokes, with an overall in-hospital mortality rate of 9.0%. Multivariate analysis revealed that a Glasgow Coma (GCS) score < 8 (AHR: 12.36; 95% CI: 2.73-56.00), National Institutes of Health Stroke Scale (NIHSS) ≥12 (AHR: 14.75; 95% CI: 3.01-72.28), moderate to severe disability (mRS ≥ 3; AHR: 9.92; 95% CI: 1.10-89.24), hemiplegia (AHR: 6.70; 95% CI: 1.835-53.748), territorial infarcts (AHR: 26.33; 95% CI: 2.093-331.203), capsuloganglionic infarcts (AHR: 14.6; 95% CI: 1.819-160.877), presence of chronic obstructive pulmonary disease (COPD) (AHR: 2.48; 95% CI: 1.317-45.091), and alcohol use (AHR: 3.87; 95% CI: 1.014-18.478) were significant predictors of in-hospital mortality. Neurological impairment at admission, specific infarct locations, hemiplegia, COPD, and alcohol use are significant predictors of in-hospital mortality among stroke patients. These findings underscore the importance of early neurological assessment, systematic risk stratification, and targeted interventions to improve stroke outcomes in resource-constrained settings
Cohort · Cohort study · Disease · Glasgow Coma Scale · Multivariate analysis · Proportional hazards model · Prospective cohort study · Stroke (engine · Acute Ischemic Stroke Management · Cardiac Arrest and Resuscitation · Stroke Rehabilitation and Recovery
| Highly cited | No |
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