From the Guidelines
The 90-day stroke mortality rate is approximately 5%, but can vary greatly from >10% to <1%, depending on the stroke mechanism. This variation in mortality rate highlights the importance of timely evaluation of stroke mechanism to identify modifiable risk factors [ 1 ]. The risk of recurrent stroke within 90 days after a first stroke is a significant concern, and effective secondary prevention strategies are crucial to reduce this risk.
Key Factors Influencing Mortality Rate
- Stroke mechanism: Symptomatic carotid stenosis and atrial fibrillation (AF) are important to diagnose in a timely fashion to allow implementation of specific treatments with proven efficacy [ 1 ].
- Timely evaluation and management of stroke mechanism can help identify modifiable risk factors and reduce the risk of recurrent stroke.
Reducing Mortality Rate
To reduce the 90-day stroke mortality rate, it is essential to implement evidence-based secondary prevention strategies, including:
- Timely diagnosis and treatment of underlying conditions such as symptomatic carotid stenosis and AF [ 1 ].
- Addressing modifiable risk factors, such as hypertension, diabetes, and hyperlipidemia.
- Implementing lifestyle modifications, including smoking cessation and regular physical activity. By prioritizing these strategies, healthcare providers can help reduce the 90-day stroke mortality rate and improve outcomes for patients with stroke.
From the Research
90-Day Stroke Mortality Rate
- The 90-day stroke mortality rate is an important metric in evaluating the effectiveness of stroke treatment and management.
- According to a study published in 2010 2, the mortality at day 90 was lower in the rtPA-treated group than the non-rtPA-treated group (18.2 versus 20.5%; p=0.827).
- Another study published in 2021 3 mentions that prior to modern therapy, post-stroke mortality was approximately 10% in the acute period, with nearly one-half of the patients developing moderate-to-severe disability.
- However, there is no direct information available on the 90-day stroke mortality rate from the other studies 4, 5, 6.
- It is worth noting that the studies provide information on the management and treatment of acute ischemic stroke, including thrombolysis and endovascular therapy, which can impact the 90-day stroke mortality rate.
- A meta-analysis published in 2021 6 found that early anti-platelet therapy after alteplase did not benefit the acute ischemic stroke patients based on the current evidence, but more clinical trials and statistical evidence are still needed.