Association of diabetes and smoking with stroke subtypes and mortality in a Saudi cohort.

Introduction: Stroke is a leading cause of morbidity and mortality in Saudi Arabia, with its incidence projected to double by 2030. Diabetes and smoking are major modifiable risk factors. This study assessed their association with stroke type and mortality in a tertiary stroke unit. Methods: We conducted a retrospective review of 336 adults admitted with acute ischemic or hemorrhagic stroke at King Fahad Hospital, Al Ahsa, between January 2023 and December 2024. Demographic characteristics, risk factors, stroke type, and mortality were analyzed using descriptive statistics and multivariable logistic regression. Smoking was not significantly associated with mortality because no deaths occurred among smokers. Conclusion: Ischemic stroke predominated, and mortality was independently associated with older age, non-Saudi nationality, and diabetes. Given the low number of deaths and limited adjustment for confounders, these findings should be interpreted cautiously and validated in larger multicenter setudies.