Stroke remains one of the leading causes of long-term neurological impairment and mortality despite its pathophysiology. Recent studies suggest that comorbidities can significantly influence post-stroke mortality and contribute to the wide variability in patient outcomes despite comparable standards of care. 

This is a Retrospective Cohort Study using MIMIC IV data (v 3.1) with data analysis conducted with R Studio 3.6.0+. ICD codes for ischemic and hemorrhagic stroke were included, regardless of age or gender. The study focused exclusively on the in-hospital mortality rate. Hypertension, diabetes mellitus, and congestive heart failure (CHF) were identified using ICD-9 and ICD-10 codes and correlated with stroke type.

This study comprised 5,735 hemorrhagic and 10,800 ischemic stroke patients. The hemorrhagic stroke group had a higher mortality rate of 0.184 with 1055 deaths compared to the ischemic group at a 0.0728 mortality rate and 786 deaths. Chi square analysis suggests that mortality rates differed significantly based on the type of stroke (??2(1) = 466.85, p < 0.001). There is also a significant difference between each comorbidity prevalence in the different stroke types. Of the 3 comorbidities analyzed, only CHF showed a significant impact on mortality rates of both ischemic (??2(1) =105.24,  p < 0.001) and hemorrhagic strokes (??2(1) =6.73, p < 0.001).

These findings highlight the importance of early intervention on CHF to mitigate mortality rates and improve mortality in ischemic and hemorrhagic stroke. Future studies may explore the mechanism of CHF exacerbations on stroke to effectively develop more targeted therapies and improve stroke outcomes.