Characteristics, risk factors and case fatality rate of stroke in hospitalized patients in semi-urban South-South Nigeria (original) (raw)
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2019
Background: Stroke is a chronic non-communicable disease results from infraction or spontaneous hemorrhage in the brain. The burden of stroke is increasing in alarming rate globally. In 2013 there were 6.5 million stroke deaths, 113 million disability-adjusted life years due to stroke from this, 75.2% of all stroke mortality and 81.0% of stroke-related disability- adjusted life years are from the developing countries. In Ethiopia, 7% of total deaths are attributed by stroke. This study aims to assess the determinants of stroke among patients with hypertension in Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia, in 2018. Methods: Hospital-based case-control study was conducted from February to April 2018. Cases were adult hypertensive patients with stroke and controls were adult hypertensive patients without stroke. Using a systematic random sampling technique 89 case and 356 controls were included in this study. Record review, physical measurement and interview te...
Vascular Health and Risk Management
Background: Globally, stroke appears as a major cause of preventable deaths and disabilities. In Ethiopia, the intra-hospital mortality of stroke is significant; however, epidemiologic data are scarce whether there is a difference in the overall survival time between hypertensive and non-hypertensive adult stroke patients admitted in specialized hospitals. This study was intended to determine the survival of stroke patients according to their hypertension status admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia from March 1, 2012, to February 28, 2019. Methods and Findings: A hospital-based retrospective cohort study was conducted among all cohorts of confirmed first-ever stroke patients admitted in Ayder Comprehensive Specialized Hospital, Northern Ethiopia. Kaplan-Meier survival analysis was applied to estimate the survival probability of hypertensive and non-hypertensive first-ever stroke patients. Cox proportional hazards regression model was used to determine the adjusted hazard ratio of death for each main baseline predictor variable with 95% CI, and P-value <0.05 was used to declare statistical significance. The assumptions of the Cox proportional hazards regression model assessed by the global test, Schoenfeld residuals. There were 503 (323 were hypertensive, 180 Non-hypertensive) confirmed first, ever adult stroke patients, the overall median age of the patients was 65 years, IQR (53-75) years. Seventy-five (14.9%) of them were dead, with a median survival time of 48 days and 428 (85.1%) of them were censored. At any particular point in time, the hazard of death among hypertensive patients was two times higher than non-hypertensive patients, but this was not found to be a statistically significant (adjusted HR=2.13: 95% CI 0.66-6.81). Glasgow Coma Scale 3-8 at admission (adjusted HR=10.12; 95% CI 2.58-40.68), presence of stroke complications (adjusted HR=7.23; 95% CI 1.86-28.26) and borderline high total cholesterol level (adjusted HR=3.57; 95% CI 1.15-11.1) were the only independent predictors of intra-hospital patient mortality. Conclusion: The overall survival time difference between hypertensive and nonhypertensive first-ever adult stroke patients was not statistically significant. Early identification and treatment of stroke complications, co-morbidities along strict follow-up of comatose patients may improve the intra-hospital survival of stroke patients, and we also recommend community-based studies using a large sample size.
International Medicine
Background: Although stroke or cerebrovascular accidents (CVA) account for the second cause of death worldwide, data on CVA in the intensive care units (ICU) of Cameroon is scant. We investigated the sociodemographic, clinical, and radiological profiles, as well as outcomes of patients with CVA admitted to the ICU of the Yaounde Central Hospital. Methods: We analyzed the hospital files of all patients admitted to the ICU of Yaounde Central Hospital from 1st January 2016 to 31st December 2016. All patients with confirmed CT-scan diagnosis of CVA were retained. Patients' files were studied for sociodemographic data, clinical variables, radiological patterns, and outcomes of ICU admission. Results: The prevalence of cerebrovascular accidents was 12.2%. The mean age was 66.2±13.5 years and 50% were males. The main reason for ICU admission was coma in 92.3%. The frequencies of comorbidities were hypertension (65.4%) and diabetes (7.7%). The main lesion for hemorrhagic CVA was at the capsulolenticular area and the main occluded vessel in ischemic CVA was the middle cerebral artery. Conclusions: The findings suggest CVA patients in the aforementioned ICU have modifiable cardiovascular factors such as hypertension and diabetes for preventive interventions. Many patients have severe hypertension on admission, reflecting uncontrolled high blood pressure before their cardiovascular event. Overall, there is an urgent need for adequate follow-up of hypertension especially in elderly patients for CVA prevention.
Stroke mortality and its predictors in a Nigerian teaching hospital
African Health Sciences, 2015
Background: Stroke is the third leading cause of death worldwide. Stroke mortality has been noted to be higher in blacks in biracial studies. There have been few studies on stroke mortality and its predictors in Nigeria. This study examines mortality of stroke and its predictors in a Northern Nigerian teaching hospital. Methods: This was a prospective study that was carried out at Jos University Teaching Hospital in Nigeria. One hundred and twenty stroke patients admitted into the medical wards within one year were assessed. Demographic data was recorded. Patients were examined and ancillary investigations were carried out. The deaths and predictors were recorded. Multivariate logistic regression was used to identify independent predictors of mortality. Results: There were one hundred and twenty participants. Forty two (35%), patients died. Most (76.2%) deaths occurred within the first week. Predictors of mortality on univariate analysis were age ≥ 60 years, male sex, loss of consciousness, high NIHSS score (≥16), the presence of co-morbid conditions and presence of complications. On multivariate analysis, the predictors of mortality were the presence of co-morbid conditions, GCS<10 and high NIHSS score. Conclusion: Stroke mortality was quite high in this study. Predictors of mortality were the indices of severity and the presence of co-morbid conditions.
Gulhane Medical Journal, 2021
Aims: Stroke is the third leading cause of disability and the second leading cause of death worldwide. Due to the effects of different factors on stroke mortality, the present study aims to determine the in-hospital mortality rate of stroke and its related factors at Ali-Ibn-Abi Talib Hospital of Rafsanjan. Methods: In this cross-sectional descriptive study, the records of all dead patients with the diagnosis of stroke at Ali-Ibn-Abi Talib Hospital of Rafsanjan were studied for the period of 2012-2017. The inclusion criteria were the definite diagnosis of stroke not longer than 72 hours from the onset of symptoms and being older than 18 years at the time of stroke. The exclusion criteria included other fatal cerebral lesions, having incomplete information for the records, death at the time of admission, and having an indefinite cause of death. Results: From among 2,199 stroke patients (the mean age was 68.46±15.67, 46% male, 54% female) who were hospitalized, 9.04% (199 patients) died during the hospitalization period. The in-hospital mortality rate was 7.54% (n=142) and 17.98% (n=57) in ischemic stroke and cerebral hemorrhage, respectively. The major risk factor percentages in died patients were 68.3% hypertension, 35.7% diabetes mellitus, 18.6% cholesterolemia. The most common fatal complications in died patients included neurological complications (48.7%, n=97), infections (23.1%, n=46), cardiac complications (18.1%, n=36), and thromboembolism (5.5%). Conclusions: Our findings are consistent with other studies about risk factors and complications of a stroke. We should focus on the prevention of complications in stroke patients by controlling important risk factors.
PLOS ONE
Background Globally, the burden of stroke is increasing at an alarming rate. Factors associated with stroke among hypertensive patients are not consistent across different studies and there are limited studies particularly to hypertensive stroke in the particular setting. This study aimed to assess factors associated with stroke among patients with hypertension in Ayder Comprehensive Specialized Hospital, Mekelle, Tigray, Ethiopia, in 2018. Methods Hospital-based case-control study was conducted from February to April 2018. Cases were adult hypertensive patients with stroke and controls were adult hypertensive patients without a stroke. Cases and controls were identified from the patient's card review. Using a systematic random sampling technique 89 cases and 356 controls were included in this study. Record review, physical measurement, and interview techniques were used to collect data. Data was entered and analyzed by using SPSS version 23. Variables with a p-value of less than 0.25 in the bivariate logistic regression were selected for multivariable logistic regression. The adjusted odds ratio and 95% confidence interval were used to determine the association. P-value <0.05 was used to declare statistical significance. Results The mean age of cases and controls were 56.3 years (SD±13.53) and 51.9 years (SD
2022
Background: Stroke is undoubtedly becoming a worldwide public health problem. Stroke-related deaths are attributable to modi able risk factors. In Ethiopia, a demographic shift increased the prevalence of stroke risk factors. Besides, there is limited critical information regarding stroke. Therefore, this study aimed to carefully assess clinical presentations, possible risk factors, and outcomes of stroke in the medical ward of Dessie comprehensive specialized hospital. Methods: A retrospective cross-sectional study design was properly employed among stroke patients. Medical records appropriately containing complete patient information and con rmed diagnosis of stroke using imaging techniques were included in the study. The necessary data were attentively entered into SPSS version 24.0 for comprehensive analysis. Results with P-value < 0.05 were considered statistically signi cant. Results: Most (51.9%) of the study participants were female. The average age of the patients was 59.2 ± 14.6 years. Many 163 (52.2%) of stroke patients lost sensation and developed weakness in their body parts. One hundred forty (44.9%) patients presented with hemiplegia/hemiparesis and 79 (25.3%) patients were unconscious. Hypertension 197 (63.1%), atrial brillation 47 (15.1%), chat chewing 46 (14.7%), and structural heart diseases 39 (12.5%) were the most traditional risk factors for stroke. The mortality rate of stroke was 21.8%, where 67 compliant patients conveniently died. Having a previous history of stroke, atrial brillation, and structural heart diseases was a predictor of risk factors for stroke-related mortality. Conclusion: Elders are more affected by stroke. Hypertension, atrial brillation, structural heart diseases, and family history of stroke are recognized risk factors for stroke. There is a high rate of stroke mortality in the hospital. Thus, establishing promotive, preventive, curative, and rehabilitative strategies are indispensable.
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.
Aetiology and prognostic factors of patients admitted for stroke
JPMA. The Journal of the Pakistan Medical Association, 2000
OBJECTIVE To see the etiology and prognostic factors related to mortality of patients with stroke. METHODS Retrospective analysis of patients admitted with stroke in two hospitals of same locality over 8 years. RESULTS Of the 12,454 cases admitted in medical units of hospital 796 (6.4%) had stroke. Majority of cases were between 4th and 6th decades of life. Fifty percent (304/606) were hypertensive, 19% (113/606) had cardiac disease and 18% (112/606) diabetes mellitus. Four percent (27/606) had previous history of stroke and 17% (102/606) were smokers. Of the 144 cases who had CT Scan 99 (69%) had infarct and 45 (31%) haemorrhage; overall mortality was 30% (288/971) and it was significantly high in cases over 60 years of age, cases with history of unconciousness at the onset and those with severe hypertension. Mortality rate in the community hospital was significantly higher (33%) as compared to private hospital (13%) (p 0.001). CONCLUSION Cardiac disease is one of the precipitating...
Profile of Cardiovascular Risk Factors in Nigerians with Stroke
World Journal of Cardiovascular Surgery, 2016
Background: There is paucity of data on cardiovascular disease (CVD) risk factors among stroke patients in our population. This study aimed at assessing CVD risk factors amongst stroke patients compared with apparently healthy controls. Methods: This was a case-control study conducted at Aminu Kano Teaching Hospital Kano. One hundred stroke subjects were consecutively recruited and compared with 100 age and sex matched controls. The CVD risk factors assessed were hypertension, diabetes mellitus, dyslipidemia, obesity, cigarette smoking, alcohol consumption, socioeconomic status (SES), increased age, male gender and Human Immunodeficiency Virus (HIV) status. Results: Mean age was 56.4 ± 15.8 years for cases and 54.5 ± 15.4 years for controls (p = 0.39), and 53% of the former and 52% of the latter were males (p = 0.887). The most prevalent CVD risk factor was hypertension, found in 71% of cases and 42% of the controls, (p = 0.01). All heart diseases were found in 70% of cases and 21% of controls (p < 0.001), and hypertensive heart disease (HHD) was the commonest, found in 55% of cases and 18% of controls (p < 0.001). Dyslipidemia was found in 53% of cases and 37% of the controls (p = 0.023), diabetes mellitus/hyperglycemia in 23% of the cases and 6% of the controls (p = 0.01), history of transient ischemic attack (TIA) in 19% of cases and 1% of the controls (p = 0.01), while atrial fibrillation was found in 9% of cases only. Other risk factors were uncommon. Conclusion: The most frequent CVD risk factors among Nigerians with stroke were systemic hypertension, heart diseases, male sex and dyslipidemia, while HIV and other risk factors were uncommon. Thus medical attention and public enlightenment should focus on the common ones as detected in this study.