In-hospital mortality and its predictors among adult ischemic stroke patients in public hospitals in the Harari region, Eastern Ethiopia: A retrospective cohort study

Background: Ischemic stroke is one of the main causes of mortality and long-term disability worldwide. Although it contributes substantially to the worldwide burden of disease, there is still a great scarcity of research on the in-hospital mortality and its predictors in Eastern Ethiopia. Therefore, this study aimed to assess in-hospital mortality and its predictors among adult ischemic stroke patients in public hospitals in the Harari region, Eastern Ethiopia. Methodology: A retrospective cohort study was conducted among 292 ischemic stroke patients in the Harari region’s public hospitals from July 1, 2019, to June 30, 2024. The incidence of mortality was calculated with a 95% confidence interval, and predictors of mortality were identified through Cox regression analyses. Results: Of the 292 patients included, 190 (65.07%) improved, 13 (4.45%) were discharged with complications, 32 (10.96%) died, and 57 (19.52%) were discharged against medical advice. The 60-month follow-up revealed a mortality rate of 7.42 (95% CI: 5.25–10.49) per 1000 person-months. The mortality risk was greater among stroke patients with diabetes (AHR: 3.31, 95% CI: 1.35, 8.14), kidney disease (AHR: 4.29, 95% CI: 1.59, 11.59), aspiration pneumonia (AHR: 4.16, 95% CI: 1.76, 9.86), and poor Glasgow Coma Scale (GCS) scores (AHR: 3.74, 95% CI: 1.14, 12.33). Conclusion: In this study, in-hospital mortality occurred in one out of nine ischemic stroke patients treated at public medical facilities. Factors such as diabetes, kidney disease, poor GCS score, and aspiration pneumonia associated with increased mortality risk. Hence, special emphasis should be given to early screening and follow-up of at-risk patients.