In-hospital mortality in stroke patients.

According to data from the World Health Organization (WHO), acute cerebrovascular disease or stroke is the third leading cause of death in the Western world, the first major cause of physical disability in adults, and the second cause of dementia in this population.1 Fifteen million persons worldwide experience stroke per year and another 5 million have permanent disability as a consequence of stroke, which implies significant repercussions on their families and society.2 About 59 million people worldwide died during 2007, and stroke was the cause of death in 10% of them. One-third of the overall mortality due to vascular disease is attributed to stroke. Moreover, because it is the most important cause of morbidity and mortality at long-term in Europe, stroke generates a tremendous economic burden. It ranks second in the burden of disease in Europe and represents 6.8% of the disability-adjusted life years (DALY); Alzheimer disease and other dementias occupy the fifth position (3%), and traffic accidents the seventh (2.5%).3 Stroke is now the second most common cause of death in Europe, following ischemic heart disease. According to data from the Instituto Nacional de Estadística (INE, National Statistics Institute), acute cerebrovascular disease was the second-ranking cause of death in the Spanish population (32 887 cases, both sexes) and the leading cause of death in women (19 038 cases) in 2006.4 The distribution of stroke as a cause of death varies between the various autonomous communities of Spain. In some communities, such as Galicia and Extremadura, it is the leading cause of death in both sexes. As occurs in ischemic heart disease, there is a marked gradient from north to south: in the southern half of Spain there is a higher rate than the country average, whereas in the north the rate In-Hospital Mortality in Stroke Patients