Determinants of survival in stroke patients: application of Cox proportional hazards regression model

Objectives Evidences showed that stroke is one of the most leading causes of death worldwide, with approximately 11.9 million new stroke patients occurring each year. Thus, the current study aimed to evaluate survival time of stroke patients and its determinants in Debre Berhan comprehensive specialized hospital. Study design and methods: A retrospective study was conducted on 259 stroke patients enrolled from 1st September 2020 to 1st December 2021. Kaplan-Meier curve and Log-rank test were used. Bivariate and multivariable Cox-PH regression models were also applied at 95% confidence level. Finally, both graphical and Schoenfeld residuals tests were used to the Cox-PH model assumptions. Results The mortality rate of stroke patients was 25.12%, and median survival time was 4.438 months. Female patients were 2.894 times more likely to die than males (AHR = 2.894, 95%CI: 1.574, 5.320). Patient age also suggested that the probability of death increased 1.041-fold for each additional month of patient (AHR = 1.041, 95%CI: 1.017, 1.065). Patients with hypertensive stroke were 2.575 times more likely to die than those without hypertension (AHR = 2.575, 95%CI: 1.295, 5.121). It has been also shown that patients with heart disease are 1. 483 times more likely to die than patients without heart disease (AHR = 1.483, 95%CI: 1.059, 1.972). Conclusion The prevalence of stroke mortality is relatively high. The patient's gender, age, hypertension, and heart disease have been shown to be contributing factors to a reduced survival time of stroke patients. Therefore, stroke patients with hypertension and heart disease, especially women, need special attention.