ObjectivesIn acute stroke, the risk of death and neurological sequelae are obvious threats. The aim of the study was to evaluate the association between various clinical factors identified by the emergency medical service (EMS) system before arriving at hospital and the risk of death during the subsequent year among patients with a confirmed stroke.Material and MethodsAll patients with a diagnosis of stroke as the primary diagnosis admitted to a hospital in western Sweden (1.6 million inhabitants) during a four‐month period were included. There were no exclusion criteria.ResultsIn all, 1,028 patients with a confirmed diagnosis of stroke who used the EMS were included in the analyses. Among these patients, 360 (35%) died during the following year. Factors that were independently associated with an increased risk of death were as follows: (1) high age, per year OR 1.07; 95% CI 1.05‐1.09; (2) a history of heart failure, OR 2.08; 95% CI 1.26‐3.42; (3) an oxygen saturation of <90%, OR 8.05; 95% CI 3.33‐22.64; and (4) a decreased level of consciousness, OR 2.19; 95% CI 1.61‐3.03.ConclusionsAmong patients with a stroke, four factors identified before arrival at hospital were associated with a risk of death during the following year. They were reflected in the patients' age, previous clinical history, respiratory function, and the function of the central nervous system.