Arboix A, Massons J, Oliveres M, García L, Titus F
Servicio de Neurología, La Alianza-Hospital Central, Barcelona.
Med Clin (Barc). 1994 Oct 29;103(14):529-33.
Few studies have been performed on mortality from acute cerebrovascular disease (ACVD) during hospital admission, particularly in Spain.
A prospective clinical analysis was performed in 1,356 consecutive patients with ACVD included in the Registry of Cerebrovascular Disease of the Central La Alianza-Hospital in Barcelona (1986-1992) with the aim of analyzing the causes of mortality during the acute phase of the disease and the time of hospital survival.
The mortality of the series was 16% (13% from cerebral infarction and 29% from cerebral hemorrhage; p < 0.0001). The causes of mortality were not neurologic in 49%, neurologic in 42% and of unknown cause in 9%. The principal causes of death were: transtentorial herniation/compression of the cerebral trunk (TH/CCT) 34%, pneumonia 14%, sepsis 14% and heart disease 11%. TH/CCT was more frequent on hemorrhage than on cerebral infarction (50% vs 27%; p < 0.001) while heart diseases were more frequent in cerebral infarction (14% vs 3%, p < 0.03). TH/CCT was the most common cause of death during the first seven days, with the pneumonia-sepsis-pulmonary thromboembolism being the most common after the third week. On the other hand, heart disease and sudden death showed homogeneous presentation with regard to frequency.
The causes of death during the acute phase of acute cerebrovascular disease are principally non neurologic (49%) being potentially preventable with the most frequent causes of death being from pneumonia, sepsis and pulmonary thromboembolism. Mortality of these patients may be decreased on correct diagnosis and treatment.
