Case-fatality and functional status three months after first-ever stroke in Vietnam

BACKGROUND: To provide novel information on outcomes after first-ever stroke in Vietnam, case-fatality and functional status were assessed 3months after stroke onset.

METHODS: First-ever stroke patients admitted to the stroke unit of a tertiary teaching hospital in Ho Chi Minh City, Vietnam were recruited, examined and interviewed. Functional status was assessed on the modified Rankin Scale (mRS) at admission and again at 3months.

RESULT: We recruited 450 consecutive first-ever stroke patients (99.6% participation, 47.9% female, mean age 62.5 [SD 14.0] years, 76.2% ischaemic stroke). Three-month observed case-fatality was 10.4%. Under plausible assumptions about deaths among non-recruited participants, the estimated case-fatality would be higher (16.4%) Those who had died were mostly older patients compromised by comorbidities and pre-existing disability, and who had severe impairment or severe disability due to stroke at the time of admission. At 3-month follow-up of 376 patients, 34% had least severe disability (mRS=0/1), 39% had intermediate disability and 28% had most severe disability (mRS=4/5). Those with least severe disability were mostly men younger than 65years of age and principally with ischemic stroke. Those with most severe disability were predominantly women aged ≥65years and those with severe disability, mainly attributable to intracerebral haemorrhage. At 3months, 50% had better functional status than at stroke onset, and 27% had poorer function.

CONCLUSION: Case-fatality was relatively low in this study, possibly because of cultural preferences for end-of-life care at home. The dependency burden was relatively high, placing pressure on the healthcare system and society.