MORTALITY IN THE ACUTE-PHASE OF CEREBROVA SCULAR-DISEASE - REGISTRY OF THE CENTRAL LA-ALIANZA-HOSPITAL IN BARCELONA (SPAIN)

Background: Few studies have been performed on mortality from acute ce rebrovascular disease (ACVD) during hospital admission, particularly i n Spain. Methods: A prospective clinical analysis was performed in 1,3 56 consecutive patients with ACVD included in the Registry of Cerebrov ascular Disease of the Central La Alianza-Hospital in Barcelona (1986- 1992) with the aim of analyzing the causes of mortality during the acu te phase of the disease and the time of hospitalary survival. Results: The mortality of the series was 16% (13% from cerebral infarction and 29% from cerebral hemorrhage; p < 0.0001). The causes of mortality we re not neurologic in 49%, neurologic in 42% and of unknown cause in 9% . The principal causes of death were: transtentorial herniation/compre ssion of the cerebral trunk (TH/CCT) 34%, pneumonia 14%, sepsis 14% an d heart disease 11%. TH/CCT was more frequent on hemorrhage than on ce rebral infarction (50% vs 27%; p < 0.001) while heart diseases were mo re frequent in cerebral infarction (14% vs 3%, p < 0.03). TH/CCT was t he most common cause of death during the first seven days, with the pn eumonia-sepsis-pulmonary thromboembolism being the most common after t he third week. On the other hand, heart disease and sudden death showe d homogeneous presentation with regard to frequency. Conclusions: The causes of death during the acute phase of acute cerebrovascular diseas e are principally non neurologic (49%) being potentially preventable w ith the most frequent causes of death being from pneumonia, sepsis and pulmonary thromboembolism. Mortality of these patients may be decreas ed on correct diagnosis and treatment.