A Stroke Study of an Urban Area of Iran: Risk Factors, Length of Stay, Case Fatality, and Discharge Destination

Background: The Iranian population is aging rapidly, which causes huge medical concern for health care of this population. This trend will lead to an increase in stroke incidence in the future. The aim of this study was to investigate the epidemiologic patterns, risk factors, length of hospitalization, hospital discharge destination, and case fatality of patients with ischemic stroke from a city of Iran as well as analyses of interaction of these factors.

Methods: A cross-sectional, multihospital-based study was performed on all consecutively discharged and diagnosed patients with ischemic stroke in the city of Qom, Iran, between March 2006 and September 2008.

Results: A total of 953 patients, 48.9% men and 51.1% women, were included. The mean age was 68+/-13.82 years. Hypertension was found in 64% of patients, followed by diabetes mellitus (36%), heart disease (34%), hypercholesterolemia (32%), and smoking (20%). The average length of stay (LOS) was 7.7 days (95% confidence interval 7.2-8.2). Women had a significantly longer LOS compared with men (8.4 v 7 days, P = .0075) and patients with heart disease had a significantly longer LOS (9 days, 95% confidence interval 7.8-10, P = .004). Overall 1-month fatality rate was 15.3%.

Conclusion: Hypertension and diabetes mellitus are more frequent here than average global findings. One-month case fatality was higher than in European countries but less than in developing countries. The most interesting difference comparing developed countries is the destination, which should be addressed. We strongly recommend establishing a stroke registry, establishing primary prevention, and promoting rehabilitation facilities in Iran.