Characteristics of morbidity and mortality from stroke in the Negev population in the years 1995 and 1999

GOALS: (1) To describe the prevalence of known risk factors for stroke morbidity and mortality in the Negev population that was hospitalized in the Soroka Hospital in the years 1995 and 1999, and to compare results. (2) To depict case fatality for those patients. METHODS: A cross-sectional study of two periods: 1995 and 1999. Data was collected from medical charts of patients admitted during the relevant time frame to Soroka Hospital in Beer Sheba, Israel with a primary diagnosis of stroke according to the ICD-9. Case fatality was defined as patient death within 30 days of admission. RESULTS: A total of 608 hospitalizations were included in the study of which 385 were admitted in 1995 and 222 in 1999. Most of the hospitalizations were due to ischemic stroke (86.7%), and the rest due to hemorrhagic stroke (13.3%). The average age was 71.1-10.9 years. Case fatality was 10.1% from ischemic stroke, 30.3% from hemorrhagic stroke and 12.5% from both. The case fatality was substantially higher in 1999. This trend was also observed in both ischemic and hemorrhagic stroke separately. There were no differences in demographic details between the years. Differences were found in various stroke risk factors. The first leukocyte count recorded was found to be significantly higher for patients who died of ischemic stroke in comparison to survivors. No differences were found between fatalities and survivors in the first reports of blood pressure. DISCUSSION: Patients in 1999 were found to have less risk factors and previously diagnosed diseases, and were admitted with more severe life threatening strokes. A logistic regression model, assessing the relationship between risk factors and case fatality, found that atrial fibrillation, type of stroke, admission leukocyte count, age and year contributed to the prediction of case fatality. Based on the results, it is recommended to use an admission leukocyte count above 11,000 to help identify patients at risk of death from stroke.