Stroke in south west Nigeria: a 10-year review (original) (raw)
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Stroke is a common neurologic disorder and it is the third leading cause of mortality worldwide after ischaemic heart disease and cancer. Males are predominantly affected and ischaemic stroke is more prevalent than haemorrhagic stroke. This study determined the pattern and presentation of stroke in Federal Teaching Hospital Abakaliki (FETHA) South-East Nigeria. It was a retrospective, descriptive and hospital based study. The stroke register of the neurology unit was reviewed and relevant data were extracted and analyzed using Statistical Package for Social Sciences (SPSS) version 19 software. The sex ratio was M:F =3:2 and the peak age prevalence of stroke was the 7 th decade. Ischaemic stroke was present in 65%, while intracerebral haemorrhage and subarachnoid haemorrhage were 31% and 4% respectively. Stroke constituted 12% of medical deaths with 30 day case mortality rate of 15%. Stroke is highly prevalent in Abakaliki south east Nigeria. The 30 day case mortality rate is relatively low in this study. There should be regular public enlightenment for stroke prevention and prompt referral of stroke patients to a stroke unit for adequate 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
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...
Stroke in Developing Countries, Experience at Kano, Northwestern Nigeria
Objectives: As no report on the clinical pattern of stroke in Kano is available, we sought to determine the stroke types, the risk factors associated with stroke, reasons for delay presentation, management issues and outcome of stroke in Kano, Northwestern Nigeria. Methods: In this prospective study, consecutive patients that were admitted to the medical wards of the two tertiary hospitals; Aminu Kano Teaching Hospital (AKTH), Kano and Murtala Muhammad Specialist Hospital, (MMSH) Kano, from June 2008 to June 2010 were recruited in the study. Diagnosis of stroke and its type were determined by clinical and neuroimaging techniques. Risk factor analysis was made based on clinical, laboratory and other relevant investigational data. The case fatality at 24 hours and 7 days were recorded. The survivors were followed in neurology clinics for 6 months; status of disability on admission and at discharge was recorded using modified Rankin disability scale. Results: Over a period of 3 years, a total of 273 comprising 179 males and 94 females (m: f = 2:1) stroke patients were recruited. Their age ranged between 18 and 90 with a mean age of 55 yrs (sd-16.5) but the mean age was 52 (s.d =17.6) in males and 60 (s.d= 11.5) in females. The peak age was in the seventh decade. One hundred and seventy four (63.7%) had infarctive stroke while ninety nine (36.3%) had haemorhagic stroke (91 intracerebral and 8 subarachnoid haemorhage). Reasons for the delay included delay referral from private hospital (49.1%), visit to traditional homes before coming to hospital (10.6%), treatment at home (7%), transportation problem (32.2%) and others (1.1%). Overall one hundred and seventy one (63%) survived and one hundred and two (37%) died. The case fatality for stroke was 10% in the first 24 hours and 22% at 7 days. Conclusion: The clinical pattern and outcome of stroke found in this study are similar to that reported in other geopolitical zones of Nigeria and other developing countries.
Stroke risk factors, subtypes, and 30-day case fatality in Abuja, Nigeria
Nigerian Medical Journal, 2013
acute stroke care, the extent of laboratory investigations, and the prediction of likely outcomes. Unfortunately, most studies on stroke in Nigeria involve little or no imaging protocols, 3-8 largely because most health centers lack facilities for computerized tomography (CT) scanning, magnetic resonance imaging (MRI), and carotid Doppler ultrasound scanning. Often, where those facilities are available, they are unaffordable. 4,7 In two studies from Southwest Nigeria, 4,6 only 2 of 101 and none of 708 patients with suspected stroke had brain CT scans. In other studies from Northwest 7 and central 8 Nigeria, brain scans were obtained in only 6 of 81 and none of 76 patients. One study 9 did not describe imaging findings altogether, and it is unclear whether patients had had brain scans. Owing to these limitations, most studies rely on World Health Organization (WHO) criteria and
Stroke Risk Factors, Subtypes, and 30-Day Case Fatality in Abuja, Nigeria (P1.121)
Neurology, 2014
acute stroke care, the extent of laboratory investigations, and the prediction of likely outcomes. Unfortunately, most studies on stroke in Nigeria involve little or no imaging protocols, 3-8 largely because most health centers lack facilities for computerized tomography (CT) scanning, magnetic resonance imaging (MRI), and carotid Doppler ultrasound scanning. Often, where those facilities are available, they are unaffordable. 4,7 In two studies from Southwest Nigeria, 4,6 only 2 of 101 and none of 708 patients with suspected stroke had brain CT scans. In other studies from Northwest 7 and central 8 Nigeria, brain scans were obtained in only 6 of 81 and none of 76 patients. One study 9 did not describe imaging findings altogether, and it is unclear whether patients had had brain scans. Owing to these limitations, most studies rely on World Health Organization (WHO) criteria and
A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria
Annals of African Medicine, 2011
Background: Stroke is a common neurological disorder and is the third leading cause of death and a major cause of long-term disability. The disease is expected to increase in low-and middle-income countries like Nigeria. There is no information on stroke in rural Nigeria. Objectives: To review the clinical patterns, risk-factors, and outcome of stroke in a tertiary hospital in rural Nigeria and examine the rural-urban variation of stroke hospitalization in Nigeria. Materials and Methods: We carried out a retrospective study of patients who had a clinical diagnosis of stroke at the Federal Medical Centre, Ido-Ekiti, Southwestern Nigeria between November 2006 and October 2009. Results: A total of 101 patients who had stroke were admitted during this review period, accounting for 4.5% of medical admission and 1.3% of total hospital admission. Women accounted 52.5% of cases, with a male to female ratio of 1 : 1.1. Their mean age was 68 ± 12 years. Stroke occurrences increased with age, as almost half (49.5%) of the cases were aged 70 years and majority (84.2%) of them were in low socioeconomic class. The mean hospital stay for stroke treatment was 12 ± 9 days, Glasgow coma score on admission was 11 ± 4. Ischemic stroke was 64.4%; hemorrhagic stroke, 34.7%; and indeterminate, 1.0%. Hypertension (85.2%), diabetes mellitus (23.8%), and tobacco smoking (22.8%) were the common identifi able risk factors for stroke. Of all the patients, 69% had 2 risk factors for stroke. Thirty-day case fatality was 23.8%; it increases with age and was higher among men than women (29.2 vs 18.9%) and in patients with diagnosis of hemorrhagic stroke (34.3 vs 18.5%). The numbers of identifi able risk factors of stroke has no effect on the 30-day case fatality. When compared with stroke in urban areas of Nigeria, we found no differences in frequency of hospitalization (1.3 vs 0.9-4%) and the major risk factor (hypertension). Hemorrhagic stroke was more common in urban than in the rural community (45.2-51 vs 34.7%) and the 30-day case fatality was lower in the rural community (23.8 vs 37.6-41.2%). Conclusion: Stroke is also a common neurological condition in rural Nigeria, in view of the fact that almost 70% of the patients had 2 risk factors of stroke. We recommend that, sustainable, community-friendly intervention programmes are incorporated into the health care system for the early prevention, recognition, and modifi cation of the risk factors in persons prone to the disease.
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.
Nigerian Journal of Medicine, 2021
Background: This study aimed to document the pattern, risk factors, in-hospital outcomes, and stroke mortality in a hospital over one year. Materials and Methods: Acute stroke patients admitted at the Lagos State University Teaching Hospital between October 2019 and September 2020 had their records reviewed. Information including age, sex, risk factors, stroke type, access to neuroimaging, and the in-hospital outcome was extracted and analyzed. Results: A total of 230 patient records were included in this study. The proportion of intracerebral hemorrhage (ICH) was 44.8%, while ischemic stroke was 52.2%. Only 9.1% of ischemic stroke cases had an onset-to-arrival time of fewer than nine hours, with just three thrombolytic therapy given. The 30-day mortality was 28.7%, lesser among younger patients and patients managed in the stroke unit. Conclusion: The hospital incidence of ICH was close to that of ischemic stroke. Mortality data confirms the importance of management in a stroke unit.
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), ...