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 3 months 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 3 months. 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 65 years of age and principally with ischemic stroke. Those with most severe disability were predominantly women aged ≥ 65 years and those with severe disability, mainly attributable to intracerebral haemorrhage. At 3 months, 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.