Frequency of Mortality and Its Associated Factors in Patients with Cerebrovascular Accidents Presenting during 2023 at the Emergency Department of Imam Khomeini Hospital in Urmia

Abstract

Background: Cerebrovascular accident (CVA) is a sudden neurological event caused by reduced cerebral blood flow. Following cardiovascular disorders and malignancies, CVAs represent the third most prevalent cause of mortality in developed nations and are identified as the primary driver of long-term disability for those who survive. This research investigates the fatality rate and independent predictors of mortality among CVA patients treated at the Imam Khomeini Hospital Emergency Department (Urmia, 2023).

Methods: This descriptive–analytical cross-sectional investigation encompassed all CVA patients admitted to Imam Khomeini Hospital during 2023, based on a census sampling approach. Information was collected using a structured checklist that captured demographic, clinical, and paraclinical characteristics. Data analysis was performed in SPSS (version 18) employing both descriptive and inferential statistical methods.

Results: Ischemic stroke represented the vast majority of events, comprising 81.6% of all cases. The overall mean age of patients was 68.4±14.6 years, and 52.7% were men. Patients with ischemic stroke had a significantly higher mean age (69.6±14.1 years) compared with those with hemorrhagic stroke (63.2±15.7 years). No meaningful difference was observed in gender distribution between the two stroke types. Length of stay in the intensive care unit and total hospitalization duration were both greater among patients with hemorrhagic stroke. The 24-hour and 30-day mortality rates following stroke onset were 1.9% and 11.7%, respectively, with significantly higher values in the hemorrhagic group. Overall in-hospital mortality was 21.7%, and mortality was more frequent in hemorrhagic stroke (45.7%) than in ischemic stroke (16.3%). Higher age, hypertension, diabetes mellitus, and pre-existing cardiovascular disease showed significant associations with in-hospital mortality.

Conclusion: Ischemic stroke was more prevalent, but hemorrhagic stroke was linked to higher mortality and a greater need for intensive care. Older age and comorbidities such as hypertension, diabetes mellitus, and cardiovascular diseases were important factors associated with in-hospital mortality.