When someone has an ischemic stroke, the most common kind of stroke, a blood clot gets lodged in an artery in the brain, blocking blood flow to part of the brain. If the clot doesn't get cleared up fast enough, that part of the brain can die. Strokes are a leading cost of death and disability. In this study, researchers in Germany were trying to figure out how to predict who is most likely to die soon after having a stroke.

What the researchers wanted to know: What are the risk factors for dying of an ischemic stroke while you're still in the hospital?

What they did: The researchers used a network of German stroke registers; 104 hospitals contribute information on the strokes that they see. They collected information on more than 13,000 patients who had strokes in 2000; 4.9 percent of them died in the hospital. The researchers looked at a whole list of variables such as age and whether the person had had a stroke before, plus complications that happened in the hospital, such as epileptic seizure and pneumonia, to see how they influenced the risk of dying from stroke.

What they found: Being old, having a more severe stroke, and atrial fibrillation all independently increased the risk of dying from stroke in the hospital. As for complications, increased intracranial pressure and pneumonia both increased the risk of dying.

What the study means to you: This will be most useful to doctors who want to know which patients are at the highest risk and which complications to pay the most attention to. They also found interesting differences between men and women—for example, while men with diabetes have a higher risk of dying from a stroke than men without diabetes, women with diabetes don't.

Caveats: The researchers only had information about what happened while patients were in the hospital, so they can't say who was more likely to die a bit later.

Find out more: Information about stroke, including warning signs, and an explanation about atrial fibrillation from the American Stroke Association.

Read the article: Heuschman, P.U. et al. "Predictors of In-Hospital Mortality and Attributable Risks of Death After Ischmemic Stroke: The German Stroke Registers Study Group." Archives of Internal Medicine. Sept. 13, 2004, Vol. 164, pp. 1761–1768.

Abstract online: http://archinte.ama-assn.org