Key result
Hemorrhagic stroke linked to ~10-fold higher mortality risk than ischemic stroke.
Why the study?
Stroke has significant public health implications globally and in Malaysia, prompting an evaluation of post-stroke survivability and major drug classes prescribed for hospitalized stroke patients.
What are the predictors of 10-day survivability and the major drug classes prescribed in patients admitted for stroke?
Cohort (n=185)
No
What are the predictors of 10-day survivability and the major drug classes prescribed in patients admitted for stroke?
In a Malaysian primary stroke center, 10-day post-stroke survival was 50.5%, with hemorrhagic stroke, multiple comorbidities, and anti-infective use associated with significantly higher mortality risk.
Answers are grounded in this paper and cite their sources.
High early mortality after hemorrhagic stroke warrants caution in resource-limited centers; leaves open optimal strategies for prospective confirmation.
Background Stroke is one of the most common noncommunicable diseases, with significant public health implications both globally and in Malaysia. The aim of this study was to evaluate post-stroke survivability as well as the major drug classes prescribed for hospitalized stroke patients. Methods A 5-year retrospective study was carried out on the survival of stroke patients admitted to Hospital Seberang Jaya, a main stroke center in the state of Penang, Malaysia. Patients admitted for stroke were first identified using the local stroke registry database, and their medical records were then accessed for data collection, which included demographic information, comorbid conditions, and medications prescribed during admission. Results The Kaplan-Meier overall survivability analysis performed indicated 50.5% survival for the duration of 10 days (p < 0.001) post-stroke. Ten-day survivability differences (p < 0.05) were observed for the categories of type of stroke (ischemic stroke (60.9%) and hemorrhagic stroke (14.1%)); stroke episodes (first (61.1%) and recurrent (39.6%)); anti-platelets (prescribed (46.2%) and not prescribed (41.5%)); statins (prescribed (68.7%) and not prescribed (28.1%)); anti-hypertensive (prescribed (65.4%) and not prescribed (45.9%)); and anti-infectives (prescribed (42.5%) and not prescribed (59.6%)) respectively. Higher risks of mortality were observed among patients with hemorrhagic stroke (HR: 10.61, p = 0.004); with 3 or more comorbidities (HR:6.60, p = 0.020); and not prescribed with statins and anti-diabetic. Patients prescribed anti-infectives, on the other hand, had a higher risk of mortality when compared to patients who did not receive anti-infectives (HR: 13.10, p = 0.019). The major drug classes prescribed for stroke patients were antiplatelet drugs (86.7%), statins (84.4%), and protein pump inhibitors (75.6%). Conclusion The findings of the study are intended to encourage more non-stroke hospitals in Malaysia to increase their efforts in treating stroke patients, as early treatment can help reduce the severity of the stroke. With the incorporation of evidence-based data, this study also contributes to local data for comparison and improves the implementation of regularly prescribed stroke medication.
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Danial et al. (2023) conducted a cohort in Stroke (n=185). Hemorrhagic stroke vs. Ischemic stroke was evaluated on 10-day survival (HR 10.61, 95% CI 2.1-53.68, p=0.004). Hemorrhagic stroke was associated with a significantly higher risk of mortality compared to ischemic stroke (HR 10.61) among patients admitted to a primary stroke center.
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