Factors Associated with Mortality Following Hospitalization for Stroke in France, 2010–2015

Background - The objective of this study was to describe early and late mortality following a stroke in France, to examine trends between 2010 and 2015, and to investigate the factors associated with these outcomes. Method - Data were extracted from the National Health Data System (SNDS). For each year from 2010 to 2015, patients aged 18 years or older hospitalized for a confirmed stroke (ischemic or hemorrhagic) were selected from the Medical Information Systems Program—Medicine, Surgery, Obstetrics (PMSI-MCO). Cox models were used to separately examine the determinants of 30-day mortality (early) and mortality at 1 year excluding the first 30 days (late) for each type of stroke: ischemic strokes or cerebral infarctions (CI), intracerebral hemorrhages (ICH), and subarachnoid hemorrhages (SAH). Results - In 2015, among the 73,124 people hospitalized for a confirmed stroke, early mortality was 15.3% and late mortality was 11.5%, resulting in a cumulative one-year mortality rate of 26.8%. Non-admission to a neurovascular intensive care unit, advanced age, the presence of comorbidities, and residing in a socially disadvantaged municipality were associated with a higher risk of early and late mortality, regardless of stroke type. Female gender was associated with lower late mortality. Between 2010 and 2015, a significant decrease in early and late mortality was observed for ischemic strokes only. Conclusions - Mortality following a stroke, both early and late, remains high in 2015, despite significant improvements in the organization of the care pathway and the deployment of neurovascular units. The high proportion of patients dying more than 30 days after hospital admission—a phase considered acute—underscores the importance of optimizing post-stroke follow-up and care coordination.

Author(s): Gabet Amélie, Grimaud Olivier, de Peretti Christine, Béjot Yannick, Olié Valérie

Publishing year: 2020

Pages: 98-107

Weekly Epidemiological Bulletin, 2020, n° 5, p. 98-107

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