ArticleBMC neurology2026
Predictors of in-hospital case-fatality in patients with stroke at the National Hospital of the Kyrgyz Republic: a retrospective cohort study.
Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStroke-related mortality remains disproportionately high in Central Asia, with Kyrgyz Republic among the most affected countries. However, evidence on predictors of in-hospital death in this setting remains limited, particularly for comparative analyses of ischemic and hemorrhagic stroke. Identifying context-specific determinants of in-hospital death is essential for informing targeted strategies to improve acute stroke care and outcomes in resource-constrained health systems.
methodsThis retrospective cohort study included 1,259 patients with stroke (1,033 ischemic and 226 hemorrhagic) admitted in 2024 to the Neurology Department No. 2 of the National Hospital of the Kyrgyz Republic. Sociodemographic, lifestyle, medical and admission-related characteristics were extracted. Multivariable logistic regression was applied separately to ischemic and hemorrhagic stroke to identify independent predictors of in-hospital case-fatality.
resultsIn-hospital case-fatality was 9.6% for ischemic and 21.7% for hemorrhagic stroke. In ischemic stroke, high Modified Early Warning Score (MEWS) (aOR = 75.1, 95% CI 29.18-193.21) and medium MEWS (aOR = 12.5, 95% CI 6.54-23.95) were strongest predictors of in-hospital case-fatality. Higher risk was noted among Bishkek residents (aOR = 4.2, 95% CI 1.72-9.94), those with prior myocardial infarction (aOR = 2.1, 95% CI 1.05-4.18) and ambulance admissions (aOR = 2.9, 95% CI 1.16-6.97). Overweight (aOR = 0.5, 95% CI 0.25-0.98) and hyperlipidemia (aOR = 0.5, 95% CI 0.26-0.84) were inversely associated with in-hospital case-fatality. In hemorrhagic stroke, high (aOR = 51.3, 95% CI 12.73-206.73) and medium (aOR = 7.5, 95% CI 2.23-25.40) MEWS, female sex (aOR = 2.8, 95% CI 1.09-7.36) and prior myocardial infarction (aOR = 5.94, 95% CI 1.45-24.29) increased case-fatality.
conclusionThis study provides early real-world, hospital-based evidence on predictors of in-hospital case-fatality among stroke patients in the Kyrgyz Republic. Early physiological risk stratification and targeted interventions for high-risk groups could improve outcomes and guide stroke care in low- and middle-income country settings.
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