Case‐fatality and disability in the Tanzanian Stroke Incidence Project cohort

Walker, Richard; Wakefield, K.; Gray, William K.; Jusabani, Ahmed; Swai, Mark; Mugusi, Ferdinand

doi:10.1111/ane.12422

Cited by 19 publications

(13 citation statements)

References 24 publications

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“…These findings could be explained by the duration of the disease; longer periods of time since the onset of stroke were associated with better acceptance of disability [85]. Most of the individuals investigated in prior studies with better SRH had mild disabilities [48] and higher survival rates [86]. In their qualitative study, Mavaddat et al [42] reported that the severity of physical limitations alone did not influence perceptions of SRH; even individuals with severe morbidities could report good SRH.…”

Section: Discussionmentioning

confidence: 99%

Self-rated health after stroke: a systematic review of the literature

et al. 2019

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Background Self-rated health (SRH) allows for comparison and identification of the health status of various populations. The aim of this study was to conduct a systematic review of the literature to expand the understanding of SRH after stroke. Methods This systematic review was registered with PROSPERO (CRD42017056194) and conducted according to PRISMA guidelines. Studies published until December 2018 that evaluated the SRH of adults with stroke were included. Results Of the 2132 identified studies, 51 were included. Only four studies had experimental designs (7.8%). In 60.7% of the studies, SRH was assessed by variations on direct questions (i.e., general and comparative SRH). Analog visual scales and quality of life instruments were also used to evaluate SRH, but there is no consensus regarding whether they are appropriate for this purpose. The results of cross-sectional and longitudinal studies revealed significant associations between poor SRH and stroke as well as between SRH, function, and disability. The power of SRH to predict stroke mortality is still uncertain. Two interventions (a home-based psychoeducational program concerning stroke health care and family involvement in functional rehabilitation) effectively improved SRH. Conclusions Direct questions are the most common method of evaluating SRH after stroke. Studies reported significant associations between the SRH of individuals with stroke and several relevant health outcomes. However, few experimental studies have evaluated SRH after stroke. Interventions involving health education and family involvement had a significant impact on SRH.

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Section: Discussionmentioning

confidence: 99%

Self-rated health after stroke: a systematic review of the literature

et al. 2019

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“…Additionally, most assessments are insensitive to ne motor skills, known as the ceiling effect, and fail to respond to the recovery of UE function in patients in the later periods of rehabilitation [20]. These limitations of the assessment scales probably result in non-selective and targeted rehabilitative training [21,22]. Therefore, an objective and sensitive assessment of UE motor function is necessary for rehabilitation at home.…”

Section: Introductionmentioning

confidence: 99%

Design a Haptic-Combined Virtual Reality System to Improve Box and Block Test (BBT) for Upper Extremity Function Assessment

Dong

Liu

Tang

et al. 2020

Preprint

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Background: The Box and Block Test (BBT) has been widely used to assess gross upper extremity (UE) motor function. We designed a haptic-combined virtual reality (VR) system, named VBBT, to improve BBT with kinematic parameters for more specific assessments.Methods: According to the block-transfer task in BBT, we designed a VBBT system with a haptic device to provide a sense of the grasping force and block's gravity during task performance for UE function assessment. Besides the number of transferred blocks (N-TB), some kinematic parameters were also collected in VBBT for more specific assessment, including the number of zero-crossings of moving acceleration (NZC-ACC), the number of zero-crossings of derivative of releasing force (NZC-DRF), the ratio of path length and linear length (PLR) and the distance between barrier partition and drop position (DDP). 16 post-stroke patients and 113 healthy subjects were recruited to examine quantitative performances, concurrent validity, test-retest reliability and subjective preference between the BBT and VBBT.Results: Based on the measurements of 95% healthy subjects, the normative ranges of quantitative performances were established for BBT and VBBT. Deficiencies in patients’ UE function could be identified when their measurements fell outsides. A moderate correlation was found in the N-TBs between the VBBT and BBT (r = 0.42). The measurements in VBBT presented a stronger age-related correlation than that in BBT (R2 = 0.57 and R2 = 0.16). The N-TBs in both BBT and VBBT were strongly correlated to the Action Research Arm Test (ARAT) (|r| = 0.84 and 0.83), and the NZC-ACC and NZC-DRF in VBBT also showed significant correlations. (|r| = 0.76 and 0.79). The N-TB, NZC-ACC and NZC-DRF in VBBT showed a good test-retest reliability (ICC = 0.75, 0.78 and 0.80) while a moderate reliability was found in BBT (ICC = 0.62). For the patient preference, VBBT was given a higher score than the BBT (p < 0.05) for its enjoyment and completion effort performing.Conclusion: The VBBT improved a gross manual assessment in BBT, which can provide clinically validated, reliable and motivative assessment with kinematic parameters for specific UE motor functions of post-stroke patients.

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“…Some of the factors cited as contributing to the increased risk of death include stroke severity, functional disability, high blood pressure, increasing age, dysphagia, and infections such as pneumonia [ 7 , 8 , 9 ]. Low survival rates after ischemic stroke have been attributed to lack of access to acute management of strokes, socioeconomic factors, and variations in geographic locations [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

Stroke Mortality in Kenya’s Public Tertiary Hospitals: A Prospective Facility-Based Study

Kaduka

Muniu

Oduor

et al. 2018

Cerebrovasc Dis Extra

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Background: Despite the increasing global burden of stroke, there are limited data on stroke from Kenya to guide in decision-making. Stroke occurrence in sub-Saharan Africa has been associated with poor health outcomes. This study sought to establish the stroke incidence density and mortality in Kenya’s leading public tertiary hospitals for purposes of informing clinical practice and policy. Methods: This is a prospective study conducted at Kenya’s leading referral hospitals, namely, Kenyatta National Hospital (KNH) and Moi Teaching and Referral Hospital (MTRH). Adult patients with confirmed cases of stroke were recruited from February 2015 to January 2016 and followed up for a minimum period of 1 year. The WHO 2006 Stroke STEPS instrument was used to collect data on incidence and mortality at days 10 and 28 and every 3 months for 24 months. The person-time of follow-up was computed from admission to death, loss to follow-up, or the end of the study. A survival regression analysis was done using the Cox proportional hazards model. Results: A total of 719 patients were recruited (KNH: n = 406 [56.5%]; MTRH: n = 313 [43.5%]). The mean age was 58.6 ± 18.7 years, and the male-to-female ratio was 1: 1.4. Ischemic stroke accounted for 56.1% of the stroke cases. The peak age for stroke was between 50 and 69 years, when 36.3% of the cases occurred. Mortality at day 10 and day 28 was 18.4 and 26.7%, respectively. The inpatient mortality rate was 21.6%. The stroke incidence density was 507 deaths per 1,000 person-years of follow-up. The mean survival time was significantly different between inpatients (13.9 months; 95% CI: 13.0–14.7) and outpatients (18.6 months; 95% CI: 17.2–19.9) (p < 0.001). A 1-year increase in age increased the hazard by 1.8%. Inpatients had a 3.9-fold increase in hazard compared to outpatients. Conclusions: Mortality due to stroke is high, with poor survival observed in the first year after stroke. The risk of death increases with increasing age and duration of hospital stay. There is need for attention to quality of care and long-term needs of stroke patients to mitigate the high mortality rates observed. Public health initiatives aimed at early screening and diagnosis should be enhanced. Further research is recommended to establish the true burden of stroke at the community level to inform appropriate mitigation measures.

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Case‐fatality and disability in the Tanzanian Stroke Incidence Project cohort

Cited by 19 publications

References 24 publications

Self-rated health after stroke: a systematic review of the literature

Self-rated health after stroke: a systematic review of the literature

Design a Haptic-Combined Virtual Reality System to Improve Box and Block Test (BBT) for Upper Extremity Function Assessment

Stroke Mortality in Kenya’s Public Tertiary Hospitals: A Prospective Facility-Based Study

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