Causes of Death in Endovascularly Treated Patients with Acute Stroke

AJNR Am J Neuroradiol. 2022 Sep;43(9):1299-1303. doi: 10.3174/ajnr.A7599. Epub 2022 Aug 11.

Abstract

Background and purpose: Because stroke therapy has changed with the introduction of endovascular stroke treatment as a standard approach, studies on intrahospital causes of death from stroke are no longer up-to-date. The purpose of this observational study was to present the causes of death during hospitalization of patients with ischemic stroke who received endovascular stroke treatment, with the focus on a differentiation of curative and secondary palliative treatment.

Materials and methods: We studied a total cohort of 1342 patients who received endovascular stroke treatment in a tertiary stroke center (Aachen, Germany) between 2010 and 2020 and analyzed the causes of death in all 326 consecutive deceased patients. We distinguished between curative treatment and a secondary palliative approach and analyzed causes of death and treatment numbers across the years.

Results: In the entire cohort of 326 deceased patients, the most common cause of death was of a cerebrovascular nature (51.5%), followed by pneumonia and sepsis (25.8%) and cardiovascular causes (8.3%). Neurovascular causes constituted 75.8% of reasons for palliation. In the group with a secondary palliative approach, causes of death were neurovascular in 54.0% of patients and pneumonia and sepsis in 26.0% of patients.

Conclusions: Cerebrovascular causes in patients with stroke play a major role in the intrahospital causes of death and reasons for palliation. Considering the large proportion of secondarily palliative-treated patients, reasons for palliation should be considered instead of causes of death to avoid concealment by, for example, life-terminating measures.

Publication types

  • Observational Study

MeSH terms

  • Causality
  • Cause of Death
  • Endovascular Procedures* / adverse effects
  • Humans
  • Pneumonia* / etiology
  • Sepsis* / etiology
  • Stroke* / etiology
  • Stroke* / therapy
  • Treatment Outcome