Mortality Rate of Acute Stroke in Iran: A Systematic Review and Meta-Analysis

Background: There is limited data about the short-term stroke mortality rates for patients in treatment settings. Objectives: This study aimed to estimate the short-term stroke (in hospital, one month, one year) mortality rates in Iran through a systematic review and meta-analysis. Materials & Methods: We searched electronic databases, including three national (IranDoc, Megiran, SID) and four international (Scopus, PubMed, Web of Science, Google Scholar), from January 1990 to March 2020. We considered all observational studies on stroke mortality, such as cohort and crosssectional studies. Furthermore, the sub-group analyses were performed based on each province and metaregression analysis based on the study’s year and patients’ mean age. Results: Among 143 studies, 28 were eligible (11 cohort and 17 cross-sectional studies). Based on the random model, the mortality rates for in-hospital, 1-month, and 1-year mortality were reported as 18.71% (95% CI: 15.09%-22.34%), 23.43% (95% CI: 20.08%-26.78%), and 34.44% (95% CI: 32.02%- 36.85%), respectively. The results also revealed that mortality rates were neither related to the year studies conducted nor to the patient’s age. Conclusion: Approximately one-fifth of stroke patients in Iran die in the hospital after admission. The mortality rate increased in the one-month and one-year period, and about one-third of the patients died in the first year. Therefore, it is cardinal to focus on programs and solutions in which we can ameliorate mortality in the short-term period after stroke by performing primary specific treatments on patients.