Epidemiology and Prognostic Factors of Stroke In Intensive Care Unit at the National University Hospital Hubert Koutoukou Maga (CNHU- HKM) of Cotonou (original) (raw)
Related papers
Epidemiology and prognostic factors of stroke in intensive care unit at
Introduction: Strokes are serious neurovascular pathologies and constitute a public health problem due to their high frequency and high mortality rate. The research aim was to assess the prognostic factors of stroke in the intensive care unit of the National University Hospital Hubert Koutoukou Maga (CNHU-HKM) of Cotonou. Materials and Methods: This was a cross-sectional, descriptive and analytical research with retrospective data collection. It took place in the intensive care unit of the CNHU/HKM at Cotonou over a period of 30 months from January 1, 2015 to June 30, 2017. The cases of stroke confirmed by a brain scanner/ MRI were included. Results: A total of 109 stroke cases were included in our research and the prevalence was 5.5%. Hemorrhagic strokes were more representative (59.6%). The mean age was 59 ± 14 years, the sex ratio was 1.22. The HBP was the most common risk factor (81.7%). Mortality was 80.07% and Anesth Crit Care 2020; 2 (1): 001-007 Anesthesia and Critical Care 2 length of stay 8 ± 9 days. The poor prognostic factors were GCS ≤ 8, the presence of neurological and respiratory complications or sepsis. Conclusions: Strokes in intensive care unit at CNHU/HKM are burdened with a high mortality rate (80.07%). The poor prognostic factors were GCS ≤ 8, the presence of neurological and respiratory complications or sepsis.
Medical complications and mortality of hospitalized stroke patients
Journal of Stroke and Cerebrovascular Diseases, 2020
Background: Stroke medical complications and mortality are not precisely known in northern Ethiopia. Hence, the main purpose of the study was to assess stroke medical complications, mortality and factors associated with mortality amongst stroke patients. Methods: A cross sectional study design was used to conduct the study. Patients medical chart was reviewed to collect patient information. Patients medical registries who were diagnosed with stroke and treated in Ayder Comprehensive Specialized Hospital were retrospectively reviewed. Sample size was estimated using single population formula. Medical charts assigned a number and patients were selected using systematic random sampling technique. The data was analyzed using SPSS version 22. Using logistic regression analysis method, factors associated with mortality in the hospital were identified. A p value less than 0.05 were deemed to be significant in all types of analyses. Results: About 216 stroke patients were studied and 126(58.3%) patients were women. A total of 48(22.2%) patients died in the hospital with median time to death of 3 days, ranged 1À48 days and average time to death of 6.2 §8.7 days. One hundred thirty-six (62.9%) patients had at least one medical complication. The total frequency of complication was 234 in number and aspiration pneumonia (n=92, 39.4%) was the frequent complication. Patients with severe (1À8) (Adjusted Odds Ratio=26.48, 95%CI: 7.11À98.58, P<0.001) and moderate (9À12) (Adjusted Odds Ratio=3.88, 95%CI: 1.05À14.39), P=0.043) record of Glasgow Coma Scale at admission were 26 times and four times more likely to die than patients with mild Glasgow Coma Scale, respectively. Conclusion: Substantially higher number of patients died at the hospital. Majority of the patients admitted to the hospital developed complication, aspiration pneumonia being the most frequently affirmed complication during their stay in the wards. Patients with severe and moderate Glasgow Coma Scale during admission were more likely to die at the hospital than patients with mild Glasgow Coma Scale. To precisely determine the mortality prevalence, medical complications frequency and to generalize the findings to the general population a multicenter prospective cohort study should be conducted.
Stroke mortality in intensive care unit from tertiary care neurological center
JNMA; journal of the Nepal Medical Association
Stroke is the second most common cause of death and major cause of disability worldwide. About a quarter of stroke patients are dead within a month, about a third by six months, and a half by one year. Although the most substantial advance in stroke has been the routine management of patients in stroke care units, Intensive Care Unit has remained the choice for stroke patients' care in developing countries. This study explores the mortality of stroke patients in ICU setting in tertiary care neurological centre in a developing country. We collected data of stroke patients admitted in our ICU from August 2009 to August 2010 and analyzed. Total 44 (10.25%) patients were admitted for acute stroke. Age ranged from 17-93 years. Low Glasgow Coma Scale (GCS), uncontrolled hypertension and aspiration pneumonia were common indications for admission in ICU. Total 23 (52.3%) patients had hemorrhagic stroke and 21 (47.7%) patients had ischemic stroke. Total 13 (29.54%) patients of stroke die...
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.
Erciyes Medical Journal, 2022
Stroke remains the second greatest cause of mortality worldwide, causing more than 5 million deaths annually. Hypertension (HTN), diabetes mellitus (DM), male sex, and an age >60 years have been associated with a higher incidence of stroke. Materials and Methods: The clinical data of 896 patients of the stroke care unit (SCU) of Tabriz University of Medical Sciences in Iran were retrieved and studied to examine the correlation between clinical features and complications. Results: Patients who presented with dysarthria, loss of consciousness, and vertigo had a significantly higher risk of mortality. A history of HTN, DM, ischemic heart disease, congestive heart failure, or carotid stenosis also meaningfully contributed to higher rates of mortality. The main complications associated with higher risks of mortality included aspiration pneumonia, pulmonary embolism, urinary tract infection, sepsis, bedsores, myocardial infarction, gastrointestinal bleeding, hydrocephaly, and brain herniation. Conclusion: Age and several other factors played a significant role in increasing the in-hospital mortality of patients admitted to the SCU. However, no significant correlation was observed between mortality and sex, previous cerebrovascular accident, or the length of in-hospital stay.
Journal of Behavioral and Brain Science, 2022
Background: Stroke patients form an integral part of patients admitted into the intensive care unit (ICU); and may need airway maintenance, supplemental oxygen and even endotracheal intubation for mechanical ventilation. Method: In this retrospective study, the medical records and radiological investigations of the patients were assessed. Also, their socio-demographics, and clinical diagnosis and background co-morbidities were noted. The radiological diagnosis post CT was used to determine the type of stroke for those compliant; while clinical assessment alone was used to determine the diagnosis in those who did not do CT. They were also classified into 2 groups: those requiring mechanical ventilation (for ICU care) and those without the need for mechanical ventilation (for high dependency Unit (HDU) care). The eventual clinical outcome was noted. Result: A total of eighty-eight cases, 67% (n = 59) were males and 33% (n = 29) females. 89.8% (n = 79) had hypertension, 3.4% (n = 3) had diabetes while 6.8% (n = 6) had both hypertension and diabetes. Of the hypertensives, 36.7% (n = 29) had hemorrhagic stroke and 66.3% (n = 50) had ischaemic stroke. 53.3% (n = 46) patients had High dependency Unit (HDU care while 47.7% (n = 42) were mechanically ventilated. Of the number in HDU, 51.5% (n = 17) were haemorrhagic, while 52.7% (n = 29) were ischaemic. Clinical diagnosis of ischemic stroke was done in 55 (62.5%) and hemorrhagic stroke in 37.5% (n = 33). Of the lot, only 19.3% (n = 17) of them did CT and 80.7% (n = 71) did not have CT done. None did MRI. Late presentation (beyond 24 hrs) was a common feature for most of the patients, for whom immediate cardio-respiratory support became necessary. Overall mortality rate was 62.5% (n = 55). 39.1% (n = 18
Trends Journal of Sciences Research
Introduction: Stroke is associated with high mortality. It is the main neurological cause of mortality and the most important cause of disability worldwide. In the year 2007, Stroke was the third cause of admission at the Korle-Bu Teaching Hospital, and the number one cause of death. Objective: To determine the probability of survival (case-fatality rates) of stroke patients admitted at the Korle-Bu Teaching Hospital during the period 2007. Method: A Retrospective descriptive study of Surgical/Medical Emergency, SME and the Medical wards admissions and discharges from 1st January 2007 to 31st December, 2007. Results: A total of 250 hospitalized stroke patients were identified, of which 68(27%) were from the SME and 182(72%) from the medical wards. The mean age (SD) was 57.6(14.7) and 52% were males. Case fatality rate was 52% at the SME versus 35% at the Medical wards) whilst the risk of death in males expressed as risk ratio (RR) was 2.1, (95% CI 0.70-5.6) vs. RR=1.3, (95% CI 0.73-2.5) in females and the median survival time was 2days (95% CI 1.5-2.4) versus 7 days (95% CI 6.3-7.6) at the SME and Medical respectively. The type of admission and stroke outcome was significant P=0.01 (95%CI 0.02-0.14). Conclusion: Stroke was associated with high mortality. The risk of dying from stroke was higher at the SME Findings were independent of stroke subtype, stroke onset and any associated co-morbidities.
International Journal of Research in Medical Sciences, 2016
Background: Acute stroke is a heterogeneous condition with respect to prognosis. This study was undertaken with the aim to evaluate the significance of routine simple blood parameters and APACHE (acute physiology, age, chronic health evaluation) III scoring system as methods of prediction of 1-month mortality in stroke patients and to assess the sensitivity and specificity of APACHE III scoring system in predicting short term outcome in critically ill patients having stroke. Methods: Patients of stroke presenting within 48 hours of onset were included in the study irrespective of age, sex or type of stroke. The clinical evaluation, neuroimaging and blood investigations were performed. APACHE III scoring system was applied for each patient to calculate the score for each one. The outcome of the patients at the end of one month was determined as survivors and expired. Results: Among the total 120 cases in the study, 54.16% (n=65) patients survived at the end of one month. The mean APAPCHE III Score among the survivors was 45.3 and in expired patients it was 88.6. Taking a cutoff value of 50, APACHE III Score was significantly associated in predicting the mortality in stroke patients (P-value<0.0001). Conclusions: The study concluded that a low GCS at the time of admission and increased serum creatinine were independent predictors of mortality among patients presenting to the hospital within 48 hours with first time acute stroke. APACHE III scoring system was found to be sensitive and reasonably specific in predicting short term outcome in patients having cerebral stroke.
Zenodo (CERN European Organization for Nuclear Research), 2022
Introduction:The Intensive Care Unit (ICU) is a special unit for treating life-threatening patients, follow-up, and life support are maintained. Patients taken care of in the emergency department ICU (EDICU) had a higher death rate of 75.4% than in the general ICU of 20.4% (P < 0.001). ICU mortality had no significant difference (P= 0.54) between women (24.4%) and men (21.1%). However, women have a 30 day mortality rate that is higher than men (44.9% vs. 30.5%; P= 0.02). The mortality rates of patients in the ICU have been reported to vary in the literature study, between 20.5% and 43%, with the most common cause of death are sepsis, cardiac and pulmonary arrest, pneumonia, and arrhythmias. Methods: This research is analytical in nature with retrospective research methods with secondary data sources obtained from ICU medical records at the HAM Hospital for the period January 2021-September 2021 Results:In the relationship between gender and the mortality of patients in the ICU from 100 patients studied, 13 female patients and 22 male patients died less than 48 hours, and patients who died in more than 48 hours consisted of 29 women and 36 males (p: 0.470). The relationship between causal diagnosis and mortality rate from 100 patients in the ICU was found that metabolic causes were the most common diagnosis, namely 12 people who died more than equal to 48 hours and 11 people who died less than 48 hours. Diagnosis of neurological causes was in second place, namely 17 people who died more than 48 hours and 6 people who died less than 48 hours. Tthe lowest causal diagnosis was hematologic origin with a total of 1 person who died more than equal to 48 hours (p: 0.426). Conclusion:Based on the results, there are no variables that have a significant effect because all variables have a p-value of more than alpha (0.05). However, if we look at the p-value, the order of variables that are close to significant are APACHE scores, anemia, platelets, SOFA scores, delay in ICU admission, blood glucose levels, body mass index, and finally age. I.