In-hospital Mortality Among Neurological Patients over the Period of 5 years — a Retrospective, Single-center Study

Abstract

Introduction. Neurological disorders have been considered for many years dangerous and are associated with higher risk of in-hospital death. Brain vascular disorders are widely considered as the most severe and related to the highest mortality rate. Aim. The aim of the study was to assess the mortality rate in subjects hospitalized in the Neurology ward within 5 years, in particular the etiology, direct cause and predictability of deaths. Material and Methods. This study is retrospective. The documentation analysis concerned the last 5 years, i.e. from 2015 to 2019. From among the entire database of 8247 patients hospitalized in the Neurology Clinic of the University Hospital No. 1 in Bydgoszcz, 429 deaths were reported and analyzed. Results. The mortality rate was 5.2% among all subjects, 6.6% among all vascular patients and 1.16% among non-vascular subjects. The highest mortality was reported among hemorrhagic stroke (28.4%) and it was significantly higher compared to ischemic stroke (OR = 6.25, 95% CI 4.9–7.8, p < 0.0001). Patients with stroke had significantly higher mortality compared to other neurological disorders (OR = 11.08 95% CI 7.7–15.9, p < 0.0001). The main direct reason of death (80%) was primary cerebral as a result of baseline disease. 7% of deaths were considered as sudden, unexpected and 10.7% were related to complications developed during hospitalization. Conclusions. Stroke, especially hemorrhagic subtype, still remains the cause of the highest in-hospital mortality rate in the Neurology Ward. It is worth to notice that special attention should be paid to patients with coexisting infectious diseases, that contribute to higher mortality risk. (JNNN 2020;9(1):20–26) Key Words: in-hospital mortality, neurological disorders, stroke, prognosis