Objective. To analyze the clinical-anamnestic, neurological, and biochemical data of patients with ischemic stroke (IS) and to compare the probability of 30-day survival in patients with and without hemorrhagic transformation (HT).

Materials and Methods. This prospective cohort study included 81 patients aged 72,2 (64,4; 81,9) years with IS, hospitalized in the neurology department of St. Panteleimon Hospital of the First Territorial Medical Association of Lviv in 2024. The study was approved by the ethics committee. All patients provided informed consent. Data collection included medical history, clinical examinations, assessment using the Glasgow Coma Scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS), instrumental (brain CT, ECG, EchoCG), and laboratory studies (complete blood count, biochemical analysis, coagulogram). The endpoints were in-hospital death and the development of HT. Survival analysis was performed using the Kaplan-Meier method.

Results. The study group was characterized by a high prevalence of comorbid cardiovascular diseases: arterial hypertension (77,3 %), coronary artery disease (61,7 %), atrial fibrillation (50,4 %), and heart failure (56,0 %). The severity of neurological deficit according to the NIHSS was 16 (12; 21) points. During the 30-day follow-up period, in-hospital mortality was 29,6 %, and HT developed in 28,4 % of patients. The Kaplan-Meier survival analysis showed that the survival probability of patients with HT significantly decreases within the first 5 days after the stroke and is substantially lower compared to patients without this complication. After day 16, the survival curves for both groups reached a plateau.

Conclusions. Hemorrhagic transformation is a critical factor that significantly worsens the prognosis and increases the risk of mortality in the acute period of ischemic stroke. The high frequency of comorbid cardiovascular pathology in patients with IS is associated with a severe course of the disease. Early prediction of the risk of HT development is key to optimizing therapeutic strategies and improving treatment outcomes.

Keywords: ischemic stroke, hemorrhagic transformation, prognosis, survival, risk factors, NIHSS

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