Ushmani Azhar, Patel Sandipkumar, Prasad Jalaja Priji, Kommineni Dheeraj, Anna Joseph Chrishanti, Bodapati Naga Venkata Satish Babu
Department of Information Security, Amazon Web Service (AWS), Dallas, USA.
Independent Research, Gujarat Technological University, Ahmedabad, IND.
Cureus. 2025 Mar 29;17(3):e81403. doi: 10.7759/cureus.81403. eCollection 2025 Mar.
Acute stroke (cerebral infarction) is a leading cause of morbidity and mortality worldwide, with patient outcomes influenced by demographic factors, comorbidities, and hospital characteristics. This study examines the differences in baseline characteristics, comorbidities, and hospital-related factors between survivors and non-survivors of acute stroke.
This study analyzed the 2023 Nationwide Readmission Database (NRD) data to identify predictors of in-hospital mortality in acute stroke (cerebral infarction). Patients were identified using the International Classification of Diseases, 10th Revision (ICD-10) codes, and exclusions included missing data, December admissions, and 30-day readmissions. Multivariable logistic regression assessed mortality risk factors, adjusting for demographics, comorbidities, and hospital characteristics (p < 0.05).
Non-survivors had a significantly higher median age (73 years vs. 71 years, p < 0.001) and included a slightly higher proportion of women (48.8% vs. 47.2%, p < 0.001). The prevalence of comorbidities, including cardiac arrest (11.9% vs. 0.7%), heart failure (35.1% vs. 0.7%), and respiratory failure (71.2% vs. 11.7%), was markedly higher among non-survivors (p < 0.001 for all). Hospitalization costs were significantly greater for non-survivors ($122,763.67 vs. $56,497, p < 0.001), and the length of stay was longer (seven days vs. four days, p < 0.001). Most admissions occurred in private non-profit hospitals, with large hospitals treating a higher proportion of non-survivors (p < 0.001).
The study highlights critical factors influencing stroke mortality, including advanced age, cardiovascular and metabolic comorbidities, and hospital resource utilization. These findings emphasize the need for early risk stratification, targeted intervention strategies, and equitable healthcare access to improve survival rates among high-risk stroke patients.
急性中风（脑梗死）是全球发病和死亡的主要原因，患者的预后受人口统计学因素、合并症和医院特征的影响。本研究探讨急性中风幸存者与非幸存者在基线特征、合并症及医院相关因素方面的差异。
本研究分析了2023年全国再入院数据库（NRD）的数据，以确定急性中风（脑梗死）患者院内死亡的预测因素。使用国际疾病分类第十版（ICD-10）编码识别患者，排除标准包括数据缺失、12月入院和30天再入院。多变量逻辑回归评估死亡风险因素，并对人口统计学、合并症和医院特征进行调整（p<0.05）。
非幸存者的年龄中位数显著更高（73岁对71岁，p<0.001），女性比例略高（48.8%对47.2%，p<0.001）。非幸存者中合并症的患病率明显更高，包括心脏骤停（11.9%对0.7%）、心力衰竭（35.1%对0.7%）和呼吸衰竭（71.2%对11.7%）（所有p<0.001）。非幸存者的住院费用显著更高（122,763.67美元对56,497美元，p<0.001），住院时间更长（7天对4天，p<0.001）。大多数入院发生在私立非营利性医院，大型医院治疗的非幸存者比例更高（p<0.001）。
该研究突出了影响中风死亡率的关键因素，包括高龄、心血管和代谢合并症以及医院资源利用。这些发现强调了早期风险分层、针对性干预策略和公平医疗服务获取的必要性，以提高高危中风患者的生存率。
