The main objective of this study was to determine the predictors of inpatient mortality of stroke among patients who were admitted to Addis Ababa University, Tikur Anbessa Specialized Teaching Hospital.

Stoke is the second most common cause of death. Recent studies in Africa have shown an alarming rise of mortality due to stroke.Tikur Anbessa Specialized Hospital is the national referral center of Ethiopia.

We conducted a review of clinical data registry of 227 patients admitted with the diagnosis of acute stroke from July 1, 2013 to June 30, 2016. We collected the socio-demographic information, detailed clinical presentation, laboratory results, imaging profiles and outcome on discharge from patient’s medical records. Univariate statistical analysis and multiple binary logistic regressions were done to identify independent predictors of mortality.

Out of 227 admitted patients, 113(49.8%), 111(48.9%), 3(1.3%) had ischemic stroke, hemorrhagic stroke and cerebral venous thrombosis respectively. Sixty-eight patients died within the hospital making the case fatality rate of 30%. The case fatality rate is higher in hemorrhagic stroke than ischemic stroke (37.8% vs. 23%, P=0.016). The following factors were significantly associated with high mortality on univariate analysis: hypertension (OR=2.106 (1.17-3.79)), fever (OR=14.29 (6.57-31.09)), shock (OR=10.04 (2.70-37.27)), oxygen desaturation ( OR=8.824, (4.63-16.81)), Glasgow coma scale ≤ 8 on initial evaluation (OR=3.722 (1.76-7.88)), swallowing difficulty (OR=9.536 (4.28-21.25)), incontinence (OR=3.382 (1.84-6.22)), speech and language disturbances (OR=4.357 (1.87-10.18)), aspiration pneumonia (OR=7.49 (3.94-14.25)), renal failure in the hospital (OR=2.19 (1.16-4.17)), delirium (OR=1.459 (1.33-1.60)), raised baseline creatinine (OR=4.128 (2.00-8.50)), leukocytosis (OR=1.95 (1.09-3.50)), and subfalcian or uncal herniation (OR=4.045 (1.57-10.41)).

Independent predictors of inpatient mortality from stroke were development of hypotension, oxygen desaturation and fever in the hospital, and subfalcian and/or uncal herniation on brain imaging.

Hemodynamic derangement and fever are significant predictors of mortality in stroke. This finding signifies the need for the establishment of a stroke unit in Ethiopia.