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Abstract

Objective:

To determine the extent that demographics, clinical characteristics, comorbidities, and complications contribute to the risk of in-hospital mortality and morbidity in acute stroke.

Methods:

Data of consecutive patients admitted to 14 stroke units cooperating within the Berlin Stroke Register were analyzed. The association of demographics, clinical characteristics, comorbidities, and complications with the risk of in-hospital death and poor outcome at discharge was assessed, and independent attributable risks were calculated, applying average sequential attributable fractions.

Results:

In a 3-year period, 16,518 consecutive patients with ischemic or hemorrhagic stroke were documented. In-hospital mortality was 5.4%, and 45.7% had a poor outcome (modifed Rankin Scale score ≥3). In patients with length of stay (LOS) ≤7 days, 37.5% of in-hospital deaths were attributed to stroke severity, 23.1% to sociodemographics (age and prestroke disability), and 28.9% to increased intracranial pressure (iICP) and other complications. In those with LOS >7 days, age and stroke severity accounted for 44.1%, whereas pneumonia (12.2%), other complications (12.6%), and iICP (8.3%) contributed to one-third of in-hospital deaths. For poor outcome, attributable risks were similar for prestroke disability, stroke severity, pneumonia, and other complications regardless of the patient's LOS.

Conclusions:

Approximately two-thirds of early death and poor outcome in acute stroke is attributed to nonmodifiable predictors, whereas main modifiable factors are early complications such as iICP, pneumonia, or other complications, on which stroke unit treatment should focus to further improve the prognosis of acute stroke.

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Supplementary Material

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COINVESTIGATOR

C. Markl-Vieto Estrada, Referat Qualitätsmanagement, Ärztekammer Berlin.

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Information & Authors

Information

Published In

Neurology®
Volume 77Number 10September 6, 2011
Pages: 965-972
PubMed: 21865573

Publication History

Received: November 11, 2010
Accepted: May 2, 2011
Published online: August 24, 2011
Published in print: September 6, 2011

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Disclosure

Dr. Koennecke has received speaker honoraria from ev3 medical, Medtronic, Inc., UCB, and Boehringer Ingelheim. Dr. Belz and Dr. Berfelde report no disclosures. Dr. Endres has served on scientific advisory boards for the Center of Stroke Research Berlin, Boehringer Ingelheim, sanofi-aventis, and Merck Sharpe & Dohme; has received funding for travel and/or speaker honoraria from Trommsdorff, GlaxoSmithKline, Bristol-Myers Squibb, AstraZeneca, Boehringer Ingelheim, Pfizer Inc, Berlin-Chemie, sanofi-aventis, Bayer Schering Pharma, Takeda Pharmaceutical Company Limited, Desitin Pharmaceuticals, GmbH, and Novartis; serves on the editorial board of Stroke, the Journal of Cerebral Blood Flow Metabolism, Cerebrovascular Disease, the Journal of Molecular Medicine, and Neuropsychopharmacology; treats stroke patients in Department of Neurology with neurointensive care and stroke unit (50% effort); and has received research support from Novartis, AstraZeneca, BMBF, DFG, EU, and the Volkswagen Foundation. Dr. Fitzek, Dr. Hamilton, and Dr. Kreitsch report no disclosures. Dr. Mackert has received funding for travel from Boehringer Ingelheim, Bayer Schering Pharma, and Merck Serono. Dr. Nabavi has received speaker honoraria from Boehringer Ingelheim, sanofi-aventis, and Trommsdorff. Dr. Nolte has received speaker honoraria from Boehringer Ingelheim and research support from the German Ministry of Research and Education. Dr. Pöhls reports no disclosures. Dr. Schmehl has received speaker honoraria from Boehringer Ingelheim and Novartis. Dr. Schmitz has served on scientific advisory boards for Pfizer Inc, GlaxoSmithKline, Novartis, Janssen, Desitin Pharmaceuticals, GmbH, and UCB; has received funding for travel and/or speaker honoraria from Pfizer Inc, GlaxoSmithKline, UCB, Desitin Pharmaceuticals, GmbH, and Janssen; serves on the editorial boards of Epilepsy and Behaviour and Zeitschrift für Epileptologie; serves on speakers' bureaus for GlaxoSmithKline, Pfizer Inc, Janssen, Desitin Pharmaceuticals, GmbH, Novartis, sanofi-aventis, UCB, Desitin Pharmaceuticals, GmbH, and Eisai Inc.; receives publishing royalties from Elsevier, Cambridge University Press, Springer, and Thieme; and has received research support from Pfizer Inc, GlaxoSmithKline, Novartis, Desitin Pharmaceuticals, GmbH, Janssen, sanofi-aventis, UCB. DFG, and Deutsche Gesellschaft für Epileptologie. Dr. von Brevern and Dr. Walter report no disclosures. Dr. Heuschmann receives research support from the EU, the German Ministry of Research and Education, University of Erlangen, German Stroke Foundation, and the Stanley Thomas Johnson Foundation.

Authors

Affiliations & Disclosures

H.-C. Koennecke, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
W. Belz, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
D. Berfelde, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
M. Endres, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
S. Fitzek, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
F. Hamilton, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
P. Kreitsch, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
B.-M. Mackert, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
D.G. Nabavi, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
C.H. Nolte, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
W. Pöhls, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
I. Schmehl, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
B. Schmitz, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
M. von Brevern, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
G. Walter, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
P.U. Heuschmann, MD
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.
For the Berlin Stroke Register Investigators
From the Department of Neurology (H.-C.K., D.B., F.H.), Vivantes Klinikum im Friedrichshain and Am Urban; Department of Neurology (W.B.), Krankenhaus Rüdersdorf; Department of Neurology (M.E., C.H.N., P.U.H.), Charité Universitätsmedizin Berlin, Center for Stroke Research; Department of Neurology (S.F.), DRK Krankenhaus Köpenick; Department of Neurology (P.K.), Helios Klinikum Buch; Department of Neurology (B.-M.M.), Vivantes Auguste-Viktoria-Klinikum; Department of Neurology (D.G.N.), Vivantes Klinikum Neukölln; Department of Neurology (W.P.), Ev. Krankenhaus Königin Elisabeth Herzberge; Department of Neurology (I.S.), Unfallkrankenhaus; Department of Neurology (B.S.), Vivantes Humboldt-Klinikum; Department of Neurology (M.v.B.), Park-Klinik Weissensee; and Department of Neurology (G.W.), Vivantes Klinikum Spandau, Berlin, Germany.

Notes

Address correspondence and reprint requests to Dr. Hans-Christian Koennecke, Department of Neurology, Vivantes Klinikum im Friedrichshain, Landsberger Allee 49, 10249 Berlin, Germany [email protected]
Study funding: Data analyses were funded by the German Ministry of Research and Education within the Center for Stroke Research Berlin.

Author Contributions

Dr. Koennecke: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, and study supervision. Dr. Belz: analysis or interpretation of data and acquisition of data. Dr. Berfelde: analysis or interpretation of data and acquisition of data. Dr. Endres: study concept or design, analysis or interpretation of data, and obtaining funding. Dr. Fitzek: drafting/revising the manuscript and acquisition of data. Dr. Hamilton: analysis or interpretation of data and acquisition of data. Dr. Kreitsch: drafting/revising the manuscript and acquisition of data. Dr. Mackert: drafting/revising the manuscript and acquisition of data. Dr. Nabavi: drafting/revising the manuscript, study concept or design, analysis or interpretation of data, acquisition of data, and study supervision. Dr. Nolte: study concept or design, analysis or interpretation of data, and study supervision. Dr. Pöhls: drafting/revising the manuscript, acquisition of data, and study supervision. Dr. Schmehl: analysis or interpretation of data and acquisition of data. Dr. Schmitz: drafting/revising the manuscript and analysis or interpretation of data. Dr. von Brevern: drafting/revising the manuscript, contribution of vital reagents/tools/patients, and acquisition of data. Dr. Walter: drafting/revising the manuscript, study concept or design, contribution of vital reagents/tools/patients, and acquisition of data. Dr. Heuschmann: drafting/revising the manuscript, analysis or interpretation of data, and statistical analysis.

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  6. Survival status and predictors of mortality among adult Stroke patients admitted to Jimma University Medical Center, South west Ethiopia: A retrospective Cohort study, Vascular Health and Risk Management, Volume 19, (527-541), (2023).https://doi.org/10.2147/VHRM.S399815
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  8. Sex Differences in the Risk of 30-Day Death After Acute Ischemic Stroke, Neurology Clinical Practice, 11, 6, (e809-e816), (2023)./doi/10.1212/CPJ.0000000000001087
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  9. Quality indicators and patients' characteristics in relation to early outcome of Kasr-al-ainy stroke unit, The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 59, 1, (2023).https://doi.org/10.1186/s41983-023-00691-x
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  10. Development and validation of a nomogram model for prediction of stroke-associated pneumonia associated with intracerebral hemorrhage, BMC Geriatrics, 23, 1, (2023).https://doi.org/10.1186/s12877-023-04310-5
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