Exploring Laboratory Predictors of Early Mortality in Patients with Stroke Referred to the Emergency Department: A Case-Control Study

Background: Considering high mortality and morbidity in patients with stroke, identification of predictors of poor prognostic outcomes after stroke is vital for stroke management strategies. This study aimed to evaluate the clinical and laboratory characteristics of patients with stroke to determine the prognostic factors of early mortality within 72 hrs of admission. Methods: This case-control study included patients with stroke attending the emergency department from March-June 2023. The patients were divided into two groups, who died early within 72 hr of admission (case group=135) and those who survived and/or expired lately after three days (control group=138). Results: The mean age of the case group was significantly higher than the control group (68.53 vs. 64.78, p=0.04). No significant correlations were found between early death and gender distribution, marital status, and type of stroke (p>0.05). The overall rate of underlying diseases in case group (85.9%) was higher (71.74%, p=0.005, OR [95%CI]:2.4[1.3_4.428]). The mean levels of WBCs, ESR, RDW-SD, triglycerides, and blood sugar in case group were significantly higher (p<0.05). Moreover, adjusted models showed that underlying disease (p=0.035, OR[95%CI]:2.034[1.052-3.934]) and high levels of WBCs (p=0.025, OR[95%CI]:1.067 (1.008-1.129)]), RDW-SD (p=0.018, OR[95%CI]:1.11[1.018-1.21]) and triglycerides (p=0.045, OR[95%CI]:1.005 [1-1.01]) were independently associated with high risk of early lethal within 72 hr. Conclusion: Older age and underlying diseases can be risk factors for stroke-related early death within 72 hr. Moreover, underlying disease and high levels of WBCs, RDW-SD, and triglycerides may independently be predictive of early in-hospital death in patients with stroke.