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

Vences M.A.; Barboza M.A.; Carbonera L.A.; Failoc-Rojas V.E.; Rosales J.; Amaya P.; Lavados P.; Alvarez M.T.R.; Gongora-Rivera F.; Olavarría V.V.; Gonzalez P.; Ciardi C.; Lylyk P.; Cirio J.J.; Llanos-Leyton N.; Rivillas J.A.; Melgarejo D.; Cardozo A.; Peralta L.; Silva-Pozo A.; Rodríguez-Kadota L.; Canales-Pichen D.; Salvador-Mateo S.L.; Vallejo S.L.; Zevallos M.G.V.; Franco A.R.; Balian N.R.; Armaretti M.S.L.; Acosta M.V.; Arancibia R.A.S.; Romero F.F.V.; Mendoza L.J.C.; Guzmán A.E.D.; Wandurraga L.F.R.; Robayo L.B.; Gallo L.M.; Carvajal F.R.; Vera E.M.; Pancorbo W.B.; Ojeda C.G.R.; Alfonso J.E.; Celis V.; Bonaglia R.D.; Rodríguez M.P.; Rodríguez R.; Pérez G.; Novarro-Escudero N.; Manrique-Otero D.M.; Callejas A.M.G.; Orozco J.E.R.; Rubio C.F.M.; Corredor L.A.S.; Arias F.E.S.; Nigenda C.V.C.; Pompa A.A.M.; Silva G.S.; Rocha E.C.A.; Cruz J.D.P.D.S. · Journal of Stroke and Cerebrovascular Diseases (2025) · DOI: 10.1016/j.jstrokecerebrovasdis.2025.108396

Resumen

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.

Instituciones: Universidad San Ignacio de Loyola; Universidad César Vallejo