Hypoalbuminemia Predicts Acute Stroke Mortality: Paul Coverdell Georgia Stroke Registry

Background: Mortality remains unacceptably high among patients hospitalized for acute stroke. Additional knowledge about factors that contribute to mortality after stroke is important for instituting therapies to lower mortality. We sought to determine the factors that predict mortality in patients hospitalized for acute stroke.

Methods: In all, 1477 consecutively admitted patients with acute stroke in 34 hospitals in the state of Georgia participating in the Paul Coverdell Georgia Stroke Registry during a 3-month period (December 1, 2001-February 28, 2002) were identified by retrospective chart review using primary or secondary International Classification of Diseases, Ninth Revision codes. Of patients, 31% were black, 65% were white, and 58% were women. We determined inhospital mortality after admission for acute stroke in this representative group of patients.

Results: There were 154 (10%) inhospital deaths among the 1477 patients admitted with acute stroke. Univariate analysis showed that mortality was associated with older age (P = .0008), stroke type (P = .0051), Glasgow Coma Scale score less than 9 (P < .0001), decreased serum albumin (P = .0001), elevated creatinine (P = .0067), and elevated blood glucose (P = .0063). In the multivariate analysis, independent risk factors for mortality after acute stroke included older age (P = .004), stroke type (P = .0007), Glasgow Coma Scale score less than 9 (P < .0001), and decreased serum albumin (P = .0003). There was no relationship between race and inhospital mortality (P = .9041). In addition, there was no association between independent predictors and race.

Conclusion: In addition to previously recognized predictors of inhospital mortality, we found hypoalbuminemia to be an independent predictor of mortality in a biracial cohort of patients with acute stroke.