Stroke mortality and its predictors in a Nigerian teaching hospital (original) (raw)
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SAGE Open Medicine, 2013
Background: Stroke causes death and disability worldwide. Hypertension is the most prevalent risk factor. In Nigeria, studies on outcome and risk factors of stroke are from urban-based hospitals. This study aims to look at stroke outcome and the major modifiable risk factors of hospitalized stroke patients in semi-urban Nigeria. Methods: The medical records of stroke patients admitted between March 2008 and February 2010 were reviewed retrospectively. The relevant demographic, clinical and laboratory data of each patient were retrieved. Results: A total of 99 cases of stroke made up of 51 males and 48 females were reviewed. Mean age of the subjects was 66.22 ± 12.67 years. Mean systolic blood pressure and diastolic blood pressure at presentation were 171.41 ± 39.10 mmHg and 100.44 ± 21 mmHg, respectively. About 61.6% were known hypertensives, while 31.3%, not previously known to be hypertensive, had SBP ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Overall, 85.9% of the subjects had SBP ≥ 140 mmHg and/or DBP ≥ 90 mmHg. In all, 46.5% had SBP ≥ 180 mmHg, and 63% of this number had SBP ≥ 200 mmHg; 42.4% had DBP ≥ 110 mmHg. Other major risk factors were hypercholesterolaemia (34.4%), diabetes mellitus (16.6%), previous cerebrovascular accident (15.2%) and smoking (9.4%). In all, 31.3% had two or more modifiable stroke risk factors. 36.4% of the subjects were comatose. Overall case fatality rate was 45.8%, 75% of the subjects with coma died, compared to 27.6% without coma (p < 0.01). Conclusion: Mortality in our stroke patients is high. Hypertension is the commonest modifiable risk factor, and the presence of coma at presentation is associated with poor prognosis.
Dutse Journal of Pure and Applied Sciences
Stroke is a cerebrovascular disease that disturbs or damages the blood supply to the brain. This study aimed to evaluate the demographic and clinical characteristics of stroke cases in Murtala Muhammed Specialist Hospital, Kano, Nigeria. Five years of records of three hundred (300) stroke patients comprised of biodata and clinical data were collected. The data were expressed as mean±SD, while simple percentage and Chi-square (χ2) tests were used to determine the incidence and association between the variables respectively using Minitab 17.0 software. The results showed an incidence of 182 (61%) males and 118 (39%) females, 265 (78%) and 65 (22%) for the above and below 40 years age groups respectively. The Hausa, Yoruba and Igbo ethnic groups have an incidence of 258 (86%), 24 (8%), and 18 (6%) respectively. The yearly incidence was 40 (13%), 50 (17%), 20 (7%), 56 (17%), and 134 (45%) for 2017 through 2021, respectively. The incidence of hemorrhagic, ischaemic, and transient i...
Universal Journal of Public Health, 2023
Introduction: Cardiovascular diseases, particularly strokes are a public health issue in Niger, a lower middle-income country. The study aimed to identify the risk factors associated with the occurrence of stroke at Niamey's national and general referral hospitals. Method: A cross-sectional study was carried out in the Niamey referral hospitals over the period January 1st, 2019 to December 31, 2021. A multivariate logistic regression model was used to identify potential predictors of stroke. Results: A total of 2,352 patients were included in the study, of whom 1,034 were diagnosed with stroke. The mean age of the patients was 59±15 years. The M/F sex ratio was 1.18. Factors associated with the occurrence of stroke were: elder age (p=0.038), female (p=0.001), unemployed (p<0.0001), lowest monthly-income (p<0.0001), family history of stroke (p=0.003), high blood pressure (p<0.0001), diabetes (p<0.0001), obesity (p=0.001), smoking (p=0.002), and hypercholesterolemia (p<0.0001). Conclusion: Socio-demographics characteristics, family history, high blood pressure, diabetes, obesity, smoking, and hypercholesterolemia increased the occurrence of stroke in Niger. It is necessary to raise public awareness of the potential predictors of stroke and to improve the technical platform for patient management.
The Prognosis of Acute Stroke in a Tertiary Health Centre in South-East Nigeria
Abstract Stroke is a common neurologic disorder and it is the third leading cause of mortality worldwide after ischaemic heart disease and cancer. This study determined the prognosis of acute stroke in Federal Teaching Hospital Abakaliki (FETHA) South-East Nigeria.It was a retrospective, descriptive and hospital based study conducted in a tertiary health centre in Abakaliki south-east Nigeria. The stroke register of the neurology unit was reviewed and relevant data were extracted and analyzed. Stroke accounted for 12% of medical death with 24hour, 7day and 30day mortality rate of 5%, 10% and 15% respectively. Factors associated with stroke mortality include advanced age, female sex, extremes of blood pressure, loss of consciousness and haemorrhagic stroke. There should be regular health education with emphasis on primary prevention of stroke. Also, stroke patients should be referred early to a stroke unit for adequate management. Key words: stroke, mortality, Abakaliki, South-East, Nigeria
Journal of Neurosciences in Rural Practice, 2023
Objectives: This research intended to examine the demographic and clinical attributes of stroke admissions in a rural Nigerian hospital. Materials and Methods: A retrospective analysis of stroke admissions was conducted over 1 year. All necessary data were obtained from patients' records and SPSS was employed for data analysis. P < 0.05 was deemed significant. Results: There were 52 stroke cases, accounting for 5.9% of medical admissions. The patients' mean age was 62.81 ± 12.71 years, while females constituted 51.9% of cases. Common risk factors included hypertension (76.9%), hyperlipidemia (38.5%), alcohol (26.9%), and diabetes mellitus (26.9%). Clinical manifestations included hemiparesis/plegia (84.6%), altered consciousness (63.5%), slurred speech (61.5%), cranial nerve deficit (61.5%), aphasia (42.3%), and headache (34.6%). Ischemic stroke (71.2%) predominated over hemorrhagic stroke (28.8%). The average hospitalization duration was 17.62 ± 8.91 days, and the mean onset to arrival time was 121.31 ± 136.06 h. Discharge and mortality rates were 82.7% and 13.5%, respectively. The association between stroke subtypes and mortality was significant (P = 0.001). Conclusion: Stroke constitutes a significant portion of medical admissions in Nigeria, with ischemic stroke being more prevalent. High mortality rates underscore the urgent need to manage risk factors to prevent stroke.
Factors associated with death and predictors of mortality in stroke in Kano
In resource-poor setting, identification of predictors of death is of paramount importance for clinicians, so that specific therapies and management strategies can be applied to patients at high risk of dying. This study aims to determine the factors associated with death and predictors of in-patient mortality for stroke among a cohort of stroke patients in two tertiary centers in Northwestern Nigeria. Materials and Methods: This was a prospective study of consecutive patients with acute stroke who were admitted to tertiary hospitals in northwestern Nigeria. A single observer, using pre-defined diagnostic criteria, recorded the information of interest including length of stay, outcome (dead or alive all through 30 days), time of death. Result: A total of 273 patients comprising 179 male and 94 female stroke patients were recruited. One hundred and seventy-four (63.7%) had infarctive stroke while 99 (36.3%) had hemorrhagic stroke (91 intracerebral and 8 sub-arachnoid hemorrhage). One-month mortality was 37%, and the majority was patients with hemorrhagic stroke (69.6%). About two-third (74.5%) of the mortalities occurred during the first week of the event. Logistic regression showed that severe systolic blood pressure, severe diastolic pressure, second or more episode of stroke, severe GCS, seizures, abnormal pupillary size, hemorrhagic stroke type, presence of aspiration pneumonitis, RBS > 200 mg/dl were independent predictors of mortality in stroke. Conclusion: The present study provides information on factors associated with death in stroke. GCS < 8, seizures, abnormal pupillary size, hemorrhagic stroke, aspiration pneumonitis were independent predictors of mortality.
Estimated probability of stroke among medical outpatients in enugu South East Nigeria
Annals of medical and health sciences research, 2014
Stroke is a growing noncommunicable disease in Africa and accounts for a substantial number of medical and neurological admissions in Nigerian hospitals. The prevalence of some risk factors for stroke such as hypertension and diabetes are high and growing among Africans. The aim was to investigate the distribution of stroke risk factors and estimate the 10-year probability of stroke among patients attending the out-patient clinics in the two biggest hospitals in Enugu South East Nigeria. Consecutive consenting patients attending out-patient clinics at University of Nigeria Teaching Hospital and Enugu state University of Science and Technology Teaching Hospital all in Enugu were enrolled. Risk factors for stroke were evaluated using a series of laboratory tests, medical history and physical examinations. The 10-year probability of stroke was determined by applying the Framingham stroke risk equation. Statistical analysis was performed with the use of the SPSS 17.0 software package (S...
Re - Appraisal Of Risk Factors For Stroke In Nigerian Africans - A Prospective Case - Control Study
African Journal of Neurological Sciences, 2008
Stroke is one of the major challenges facing medicine with a frightening statistics of being the second leading cause of death and the leading cause of physical disability worldwide. Identification and management of risk factors remains the key to reducing morbidity and mortality from stroke. Eighty patients with clinical presentation of stroke were recruited consecutively from the Emergency Departments of the University Teaching Hospital and Specialist Hospital-both situated in Benin City, Nigeria. The patients were followed up for a two year period (June 2000-June 2002) and risk factors analysis was done on all patients. The patients were compared with eighty age and sex matched subjects without stroke (controls). Hypertension remained the dominant risk factor with an odds ratio of 2.68 (95% CI 1.29-5.59). Diabetes mellitus independently conferred a risk of 3.23 (95% CI 1.09-5.71) and in combination with hypertension enhanced stroke risk (odds ratio 7.21; 95% CI 5.79-13.27; p<0.05). Cigarette smoking, obesity, atrial fibrillation and physical inactivity significantly increased stroke risk (p<0.05). On the other hand, dietary habits, alcohol consumption and serum cholesterol were not important risk factors in Nigerians. This study emphasized the significance of optimal blood pressure and glycemic control in stroke prevention. The message for all is to exercise, maintain a healthy weight, avoid smoking and monitor blood pressure and glucose levels regularly.
Cardiology & Vascular Research, 2021
Introduction: Despite the high burden of stroke globally, there is an observed paucity of data regarding its subtypes, risk factors and treatment outcomes in rural Southwestern Nigeria. The study ascertained the subtypes, risk factors and treatment outcomes of stroke at the adult Accident and Emergency Department of a tertiary hospital in a rural Southwestern Nigeria. Materials and methods: A retrospective survey using data form and standardized questionnaire was used to review the patients admitted for stroke between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: In this study, 276 stroke patients comprised Ischemic (60.1%) vs Hemorrhagic (39.9%) strokes were studied. The mean age of the patients was 67.3±11.1 years. The majority were males and were older than 65 years. The independent predictors of stroke admissions were Informal education [(AOR = 0.288; 95% CI: (0.120-0.691), ...
Predictors of 30 days outcome of patients with acute stroke in Sokoto
Sahel Medical Journal, 2011
Background: Though the epidemiologic profile of patients with acute stroke has been described in the sub Sahara African region, little is known about predictors of mortality in patients with acute stroke. This study aimed to determine the predictors of 30-day mortality of acute stroke so that early therapeutic measures could be instituted to improve functional outcome. Methods: Case records of patients admitted from January 2007 to December 2009 with clinical diagnosis of stroke were retrieved. Relevant clinical data were extracted using structured questionnaire. Results: A total of 370 case files with clinical diagnosis of stroke were traced but only 260 had complete information. The mean age of patients was 55.7±14.3 years; Hypertension was the most common modifiable risk factor for stroke followed by diabetes mellitus. The 24-hour and 30-day case fatalities were 11.9% and 38.4%, respectively. Predictors of 30-day mortality were admission blood glucose, level of consciousness and age at stroke. Conclusion: The 30-day case fatality of acute stroke was high and predictors of outcome included old age reduced level of consciousness and elevated blood glucose at presentation.