Predictors of In-Hospital Mortality Among Patients With Acute Stroke: Insights From the Healthcare Cost and Utilization Project (HCUP) Nationwide Readmission Database
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: 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. METHODS: 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). RESULTS: 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). CONCLUSION: 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.
Source: Cureus
DOI: 10.7759/cureus.81403
Authors: Azhar Ushmani, Sandipkumar Patel, Priji Prasad Jalaja, Dheeraj Kommineni, Chrishanti Anna Joseph, Naga Venkata Satish Babu Bodapati
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4408954718