Association Between Early Coagulation Disorder and All-Cause Mortality in Critically Ill Stroke Patients: A Retrospective Study Based on the MIMIC-IV Database.

BackgroundThe clinical relevance of the early coagulation disorder (ECD) score, derived from platelet count, international normalized ratio (INR), and activated partial thromboplastin time (APTT), in patients with stroke remains unclear. This study aimed to evaluate the association between ECD score at intensive care unit (ICU) admission and all-cause mortality (ACM) in patients with stroke.MethodsThis retrospective cohort study utilized data from the MIMIC-IV database. The primary outcome was 30-day all-cause mortality; secondary outcomes included 90-day and 1-year all-cause mortality. Kaplan-Meier curves and multivariable Cox models were used to assess associations between ECD scores and outcomes. Subgroup analyses and interaction tests were conducted to verify robustness.ResultsAmong 5753 participants (median age 70.97; 52.03% male), the 30-day mortality rate was 17.17%. Kaplan-Meier analysis showed significantly higher mortality in patients with ECD (log-rank P < 0.01). Multivariable analysis indicated increased risks of mortality within 30 days in patients with ECD (HR = 1.374, 95% CI: 1.174-1.608) and those with ECD scores of 5-6 (HR = 1.374, 95% CI: 1.011-1.868) compared to those without ECD or with a score of 0, respectively. Subgroup analyses supported these findings.ConclusionElevated ECD scores are associated with increased mortality in critically ill patients with stroke. Comprehensive coagulation assessment may improve clinical management and risk assessment.