PREDICTIVE CLINICAL FACTORS OF IN-HOSPITAL MORTALITY IN 231 CONSECUTIVE PATIENTS WITH CARDIOEMBOLIC CEREBRAL INFARCTION

Cardioembolic cerebral infarction is a subtype of stroke with a high m ortality. The purpose of this study was to determine predictors of in- hospital mortality in 231 consecutive patients with cardioembolic stro ke by means of a multivariate analysis. Three predictive models were c onstructed. A first model was based on demographic, anamnestic and cli nical variables collected at the bedside examination (total 8 variable s). A second model was based on clinical and neuroimaging variables (t otal 10 variables). A third model was based on the aforementioned clin ical and neuroimaging variables and the presence of early recurrent em bolism (total 11 variables), Deteriorated level of consciousness, limb weakness, presence of congestive heart failure, male gender, and age appeared to be independent prognostic factors of in-hospital mortality in the predictive model based on clinical variables and in the predic tive model based on clinical and neuroimaging variables. In addition t o these variables, early recurrent embolization was selected in the th ird predictive model. In the first two models, setting a cut-off point of 0.50 for predicting vital status at hospital discharge resulted in a sensitivity of 60%, a specificity of 89% and a total correct classi fication of 81%. The corresponding values of the third model were 62, 89 and 81%, respectively. These data may help clinicians to establish an early prognosis of this stroke subtype more accurately as well as t o allocate patients with cardioembolic stroke in clinical trials corre ctly.