Key result
Age ≥75 is linked to ~5.9-fold higher in-hospital stroke mortality vs ages 45–54.
Why the study?
Most Angolan patients with stroke reach the hospital beyond the thrombolysis window and many deaths occur within 72 h of admission, motivating an investigation of routinely recorded variables associated with in-hospital mortality.
Cohort (n=479)
No
Odds Ratio: 5.92 (95% CI 2.28–15.38)
Absolute Event Rate: 28% vs 6.7%
p-value: p=0.0003
In a public tertiary hospital in Angola, in-hospital stroke mortality was 15.7%, driven primarily by older age (≥75 years) and early haemorrhagic stroke deaths among patients younger than 45 years.
Age ≥75 years associated with higher Angolan stroke mortality; extends sparse sub-Saharan data but hypothesis-generating and should not yet change practice.
Background Most Angolan patients with stroke reach hospital beyond the thrombolysis window, and many deaths occur within 72 h of admission. We investigated routinely recorded variables associated with in-hospital mortality at Hospital do Prenda. Methods We conducted a single-centre retrospective cohort study at Hospital do Prenda, a public tertiary hospital in Luanda, from January 2023 to December 2025. The unit of analysis was the hospitalisation episode; four episodes ending in transfer were excluded. Hypertension and type 2 diabetes were extracted from free-text fields using predefined string rules. Univariable analyses used Pearson chi-square, crude odds ratios (OR; 95% CI), and Mann–Whitney tests. Exploratory multivariable logistic regression adjusted for age, sex, year, stroke subtype, recorded comorbidities, and head-CT status. Given the low events-per-variable ratio (~7) and poor calibration in some models, adjusted estimates were considered exploratory associations rather than independent prognostic effects. Results Among 479 episodes, 75 patients died (15.7%; 95% CI 12.7–19.2). Median age was 58.5 years among decedents versus 52.0 among survivors ( p = 0.049). Median length of stay was 3 versus 6 days ( p < 0.0001), reflecting early mortality rather than a prognostic exposure. Mortality increased from 6.7% at age 45–54 years to 28.0% at ≥75 years and remained graded after adjustment (≥75 years: adjusted OR 5.92, 95% CI 2.28–15.38; p = 0.0003). Mortality among patients <45 years was also elevated (17.2%; adjusted OR 2.97, 95% CI 1.28–6.87), predominantly among haemorrhagic strokes (22.2% versus 10.8% for ischaemic stroke; age-by-subtype interaction p = 0.0009). Sex, year, stroke subtype, recorded hypertension, and diabetes were not associated with mortality. Absence of head CT showed higher crude mortality (30.0% versus 15.0%; OR 2.42, 95% CI 0.90–6.52). Recorded hypertension prevalence was only 19.8%, indicating substantial under-ascertainment. Conclusion Older age was the strongest admission-available correlate of in-hospital mortality, while elevated mortality among younger patients was concentrated in haemorrhagic stroke. Under-ascertainment limits interpretation of comorbidities. Absence of stroke-severity, functional-status, ICU, ventilation, and reperfusion data further limits causal or independent prognostic inference.
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Neto et al. (2026) conducted a cohort in Stroke (n=479). Age ≥75 years vs. Age 45–54 years was evaluated on In-hospital mortality (OR 5.92, 95% CI 2.28-15.38, p=0.0003). Older age (≥75 vs 45–54 years) was strongly associated with increased in-hospital stroke mortality (28.0% vs 6.7%; adjusted OR 5.92, 95% CI 2.28–15.38, p = 0.0003).
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