From the Guidelines
The 90-day stroke mortality rate is not explicitly stated in the provided evidence, but the risk of recurrent stroke within 90 days after a first stroke is approximately 5%. This risk can vary greatly, from more than 10% to less than 1%, depending on the stroke mechanism [ 1 ].
Key Factors Influencing Mortality and Recurrence
- Symptomatic carotid stenosis and atrial fibrillation (AF) are crucial to diagnose in a timely manner to implement specific treatments with proven efficacy [ 1 ].
- The risk of stroke within 90 days after a first stroke highlights the importance of effective secondary prevention, which includes timely evaluation of stroke mechanism to identify modifiable risk factors [ 1 ].
Reducing Mortality and Recurrence
To minimize the risk of recurrent stroke and potentially reduce mortality, it is essential to focus on the prevention and management of modifiable risk factors, including:
- Timely diagnosis and treatment of conditions like symptomatic carotid stenosis and AF [ 1 ].
- Implementation of specific treatments with proven efficacy for these conditions. Given the information provided, the emphasis is on the prevention of recurrent stroke rather than directly on mortality rates. However, by reducing the risk of recurrent stroke through timely and effective management, it is possible to indirectly influence mortality rates positively.
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.
- 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).
- However, another study published in 2011 3 mentions that initiating treatment after 4.5 hours increases mortality and reverses the risk-benefit balance, but does not provide a specific 90-day mortality rate.
- A study published in 2021 4 mentions that prior to modern therapy, post-stroke mortality was approximately 10% in the acute period, but does not provide a specific 90-day mortality rate.
- There is limited information available on the exact 90-day stroke mortality rate, and more research is needed to determine the current mortality rate with modern stroke treatment.
- Studies have shown that thrombolytic treatment, such as rtPA, can improve clinical outcomes in acute ischemic stroke patients, including those with atrial fibrillation 2.
- The use of intravenous recombinant tissue plasminogen activator (IV TPA) and/or endovascular thrombectomy has been shown to be beneficial in select patients with acute stroke caused by occlusion of the proximal anterior circulation 4.