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Heart Failure, Dementia is Associated with Increased Stroke Severity, in-Hospital Mortality and Complications
Lijun Zuo, Yanhong Dong, Yang Hu, Zixiao Li, Hongqiu Gu, Xingquan Zhao, Yongjun Wang. ESC Heart Failure, 2025-03-24
Topic: Risk, prevention and care in population studies
Patients in this study were from the China Stroke Center Alliance database. We divided patients into four groups: (A) stroke patients with dementia but no HF; (B) stroke patients with HF but no dementia; (C) stroke patients with both dementia and HF; (D) stroke patients without HF or dementia. We analysed the in-hospital mortality, and complications among the 4 groups. Outcomes include in-hospital mortality and in-hospital complications, including pneumonia, decubitus ulcer, pulmonary embolism, myocardial infarction, gastrointestinal bleeding and deep vein thrombosis (DVT). Multivariable logistic regression was performed to validate the association between HF, dementia, stroke and functional outcomes. Stroke patients with dementia and HF were older, and had a higher proportion of individuals with a history of strokeperipheral vascular disease and dyslipidaemia, and had a higher level of homocysteine, glycosylated hemoglobin and so on. Compared with group D (stroke patients without HF or dementia), all the other three groups have significantly higher proportion of in-hospital mortality and complications, such as pneumonia, decubitus ulcer, pulmonary embolism, myocardial infarction, DVT, gastrointestinal bleeding and poor swallow function. When compared with group B (stroke patients with HF but no dementia), the in-hospital mortality was higher in group C (stroke patients with HF and dementia), but the difference was not statistically significant; the prevalence of decubitus ulcer, gastrointestinal bleeding and poor wallow function were significantly higher in group C. In the logistic regression, the stroke patients with dementia and HF showed significant higher in-hospital mortality (adjusted OR, 2.875; 95% CI, 1.539-5.371; P = 0.001) and higher proportion of pneumonia (adjusted OR 2.596, 95% CI, 2.027-3.325, P < 0.001), decubitus ulcer (adjusted OR, 6.473, 95% CI, 3.999-10.477, P < 0.001) and pulmonary embolism (adjusted OR, 2.876, 95% CI, 1.054-7.850, P = 0.039). Stroke patients with dementia and HF have an increased risk of in-hospital mortality and complications. Future studies should strengthen the risk factor control among individuals with both dementia and HF for stroke prevention.
Key findings
- Patients in this study were from the China Stroke Center Alliance database.
- We divided patients into four groups: (A) stroke patients with dementia but no HF; (B) stroke patients with HF but no dementia; (C) stroke patients with both dementia and HF; (D) stroke patients without HF or dementia.
- We analysed the in-hospital mortality, and complications among the 4 groups.
- Outcomes include in-hospital mortality and in-hospital complications, including pneumonia, decubitus ulcer, pulmonary embolism, myocardial infarction, gastrointestinal bleeding and deep vein thrombosis (DVT).
- Multivariable logistic regression was performed to validate the association between HF, dementia, stroke and functional outcomes.
Why it matters
In this study of stroke patients, those with both heart failure and dementia had higher in-hospital mortality and more complications than those with heart failure alone or neither condition. The study examines outcomes after stroke and does not test any treatment, cure, or prevention for Alzheimer's disease.
Study details
- Effect sizeOR 2.596
- Evidence strengthLow
How this study scored 42/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (ESC Heart Failure) |
| Journal's citation record | 1 / 4 | ESC Heart Failure: journal h-index 79 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Yongjun Wang: h-index 51 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | National University of Singapore: institution h-index 1,166 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40128911) |
| Free to read | 2 / 2 | Free to read |
| Total | 42 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Zuo, L., Dong, Y., Hu, Y., Li, Z., Gu, H., Zhao, X., et al. (2025). Heart Failure, Dementia is Associated with Increased Stroke Severity, in-Hospital Mortality and Complications. ESC Heart Failure. https://doi.org/10.1002/ehf2.15216
Vancouver
Zuo L, Dong Y, Hu Y, Li Z, Gu H, Zhao X, et al. Heart Failure, Dementia is Associated with Increased Stroke Severity, in-Hospital Mortality and Complications. ESC Heart Failure. 2025. doi:10.1002/ehf2.15216. PMID: 40128911.
BibTeX
@article{zuo2025-40128911,
author = {Zuo, Lijun and Dong, Yanhong and Hu, Yang and Li, Zixiao and Gu, Hongqiu and Zhao, Xingquan and Wang, Yongjun},
title = {{Heart Failure, Dementia is Associated with Increased Stroke Severity, in-Hospital Mortality and Complications}},
journal = {ESC Heart Failure},
year = {2025},
doi = {10.1002/ehf2.15216},
pmid = {40128911},
url = {https://doi.org/10.1002/ehf2.15216}
}
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