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

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Acute ischemic stroke (n=2997). Intervention: Acute ischemic stroke. Primary outcome: 30-day case-fatality.

Q: What does this research mean for the field?

Among acute ischemic stroke patients in Latin American stroke centers, 30-day case-fatality is 10.2%, with stroke severity (NIHSS >26) being the strongest predictor of mortality. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Miguel A. Vences; Miguel A. Barboza; Leonardo Augusto Carbonera; Virgilio E. Failoc‐Rojas; Julieta Rosales; Pablo Amaya; Pablo M. Lavados; María Álvarez; Fernando Góngora‐Rivera; Verónica V. Olavarría; Pablo A. González; Celina Ciardi; Pedro Lylyk; Juan Cirio; Natalia Llanos‐Leyton; Julián Alejandro Rivillas; Donoband Melgarejo; Analia Cardozo; Lorena Gallardo-Peralta; Andrés Silva-Pozo; Liliana Rodríguez-Kadota; Diego Canales; Sara Lorena Salvador-Mateo; Sebastián León-Vallejo; Mariángel Gabriela Vásquez Zevallos; Angelica Ruiz Franco; Natalia Balián; Marianela Soledad Lopez Armaretti; Felipe Romero; Andrés Eduardo Diaz Guzmán; Luis Roa; Laura Boada Robayo; F Carvajal; Esteban Montoya Vera; William Bayona Pancorbo; Jorge Emilio Alfonso; Violeta Celis; Rodrigo Décima Bonaglia; María I. Rodríguez; Ramiro Rocha Rodríguez; Gonzalo Pérez; Nelson Novarro; Diana Manrique-Otero; Ana María García Callejas; Jaime Eduardo Rodriguez Orozco; Carlos Fernando Martinez Rubio; Laura Andrea Serna Corredor; Fabiola Serrano; Claudia Vanessa Cano Nigenda; Alessandra Pompa; Gisele Sampaio Silva; Eva Rocha; J M Cruz

doi:10.1016/j.jstrokecerebrovasdis.2025.108396

July 15, 2025Journal of Stroke and Cerebrovascular DiseasesOpen Access

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

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Key result

Severe ischemic stroke with NIHSS >26 is linked to a ~6-fold higher 30-day mortality risk.

n=2,997

Key Points

To evaluate in-hospital, 30-day, and 90-day case-fatality rates and identify independent clinical predictors of early mortality among acute ischemic stroke patients.
Conducted a retrospective multicenter cohort study of N=2,997 adult acute ischemic stroke patients hospitalized across 27 stroke centers in 11 Latin American countries during 2022.
Used multivariable Cox proportional hazards regression models to calculate adjusted hazard ratios (aHR) and 95% confidence intervals for time to 30-day case-fatality.
In-hospital case-fatality was 9.42%, 30-day fatality reached 10.2% (277/2,716 evaluated), and 90-day fatality was 13.3% (353/2,654 evaluated), with medical complications occurring in 31.3% of patients (infections in 18.5%).
Significant independent predictors of 30-day fatality included age over 75 years (aHR 2.28), baseline functional status (aHR 1.61), hyperglycemia (aHR 1.28), severe stroke with NIHSS >26 (aHR 6.11), and neurological complications (aHR 3.2).

Study Design

Type

Cohort (n=2,997)

Multicenter

Yes

Structured PICO

P

Population

2,997 hospitalized acute ischemic stroke patients over 18 years of age across 11 Latin American countries, followed for up to 90 days.

O

Outcome

Case-fatality rates (in-hospital, 30 and 90 days follow up) and associated risk factorshard clinical

Implication

In Latin American stroke centers, acute ischemic stroke carries a 30-day case-fatality of 10.2%, strongly predicted by older age, stroke severity, and neurological complications.

Discussion

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Cite This Study

Vences et al. (2025) conducted a cohort in Acute ischemic stroke (n=2,997). Acute ischemic stroke was evaluated on 30-day case-fatality. Among 2,997 acute ischemic stroke patients in Latin America, 30-day case-fatality was 10.2%, with stroke severity (NIHSS >26) being the strongest predictor of 30-day mortality (HRa 6.11).

synapsesocial.com/papers/6a82310d70df46ce3ea20d34 https://doi.org/10.1016/j.jstrokecerebrovasdis.2025.108396

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

Key Points

Study Design

Structured PICO

Implication

Discussion

Cite This Study

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

Key Points

Study Design

Structured PICO

Implication

Discussion

Cite This Study

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