Clinical Characteristics, Treatment Outcomes, and its Predictors Among Hospitalized Stroke Patients in Ambo University Referral Hospital, West Ethiopia: A Retrospective Hospital-Based Study

Gadisa, Diriba Alemayehu; Busawa, Guye Betero; Gebremariam, Esayas Tadesse; Tefera, Gosaye Mekonen; Belete, Kefyalew Taye; Taye, Getu Melesie; Meskele, Lemma Bose; Gudeta, Biruk Mosisa; Gelaw, Belayneh Kefale

doi:10.2147/vhrm.s287465

Cited by 17 publications

(15 citation statements)

References 41 publications

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“…In the present study, 59.26% were uneducated, 54.21% were from lower socio economic status, and 67.84% were from rural areas. Similar to the present study, Gadisa DA et al 4 (2021), in their study observed that 61.3% of the study subjects were unable to read and write, and 64% were from 6 rural areas. Kefale B et al , in their study, also observed a higher proportion of study subjects from rural areas (53.4%).…”

Section: Baseline Socio-demographic Characteristicssupporting

confidence: 90%

Epidemiological Profile and Issues of Acute Stroke Management in a Tertiary Care Hospital - A Prospective Longitudinal Study of Southern Coastal India.

Kumar

Sunanda²,

Sanjana

et al. 2022

PIJR

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Objective: The World Health Organization (WHO) estimates that nearly 15 million patients worldwide suffer from stroke annually. Diverse demography and limited national health resources contribute to the difficulty in neuroepidemiological studies, which will effectively guide health care professionals to treat patients of that particular region. In this study we tried to explore the epidemiological parameters and deficits of acute stroke management. Materials And Methods: Current study is a prospective longitudinal study of 653 acute stroke patients presenting to the departments of Neurology, Emergency medicine of Narayana Medical College, over a period of 2 years (April 2018 to March 2020). Demographic parameters were considered as Primary observed variables. Statistical Analysis: Descriptive analysis was performed by the mean and standard deviation for quantitative variables, frequency, and proportion for categorical variables. Of the 653 patients, 317 (49%) were males and 336(51%) were fe Results: males. Mean age for stroke was 61.6 years. Majority of them were from rural background, have nil education status, married, house wives and from low socioeconomic status. 69% were not aware of any vascular risk factors for stroke/ CAD. Awareness of other vascular risk factors like diabetes, hypertension was in 34% while that of treatment options like thrombolysis was in 12% patients only. Alcohol consumption was present in 41% and smoking in 38% patients. Most common time of symptom onset was 6-12 hours. Majority of the first evaluated areas was emergency department. 49% patients consulted health care facility after window period, most common reason for delay being inability to recognize symptoms followed by lack of transportation Assessment of patient's socio economic and educational Conclusion: status, knowing the patient's awareness of vascular risk factors and management aspects of stroke with early recognition of symptoms and signs help us in strengthening the health care system, there by reducing morbidity and mortality of stroke in countries like India, where the major population is from rural background.

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Section: Baseline Socio-demographic Characteristicssupporting

confidence: 90%

Epidemiological Profile and Issues of Acute Stroke Management in a Tertiary Care Hospital - A Prospective Longitudinal Study of Southern Coastal India.

Kumar

Sunanda²,

Sanjana

et al. 2022

PIJR

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“…This study showed that the cumulative incidence and the incidence density rate of aspiration pneumonia were 131/568 (23.06 percent) and 38/1000 persons day-observation respectively. This cumulative incidence was higher than the reports from studies conducted in Nigeria (12.40 percent), China (13.20 percent), United Kingdom (7.12 percent) and USA (5 percent) [14,16,33,53] and less than studies conducted in Egypt (40 percent) and India (32 percent) [15,20]. The discrepancy may be due to the differences in post-stroke patient care and different diagnosis approaches of post-stroke aspiration pneumonia or the study design used.…”

Section: Discussioncontrasting

confidence: 59%

“…Despite the different preventive and therapeutic approaches being practiced for patients with post stroke aspiration pneumonia at health facilities level, patient morbidity and mortality is still increasing (incidence up to 83 percent and mortality rate up to70 percent)[6, [12][13][14]. The global incidence of aspiration pneumonia among post stroke patients is 14 percent.…”

Section: Introductionmentioning

confidence: 99%

Incidence and Predictors of Aspiration Pneumonia among Stroke Patients in Western Amhara Region, North-West Ethiopia: A Retrospective Follow up Study

Bayeh

Muluneh

Wassie

2022

Preprint

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Background: Aspiration pneumonia is one of the major complications among hospitalized stroke patients with global incidence ranging from five to 83 percent and hospital mortality rate of up to 70 percent. This study aimed to assess the incidence and identify predictors of aspiration pneumonia among stroke patients in Western Amhara region, North West Ethiopia.Methods: An institution-based retrospective follow-up study was conducted on a simple random sample of 568 stroke patients in Western Amhara region admitted at Felege Hiwot referral hospital. Log binomial regression model, a generalized linear model with log link, was applied to identify significant predictors of aspiration pneumonia.Results: Cumulative incidence of aspiration pneumonia among the 568 sampled patients was 23.06%. Males were 1.71 times more at risk to acquire aspiration pneumonia than females (ARR=1.71, 95 percent CI 1.07-2.74). Patients with vomiting and dysphagia were more risky to acquire aspiration pneumonia as compared to patients without vomiting and dysphagia (ARR=1.81, 95 percent CI 1.04-3.14) and (ARR=1.95, 95 percent CI 1.10-3.48) respectively. Patients who received antibiotic prophylaxis and patients with Glasgow Comma Scale greater than twelve were less risky to acquire aspiration pneumonia as compared to who not received antibiotic prophylaxis and Glasgow Comma Scale less than eight (ARR=0.10, 95 percent CI 0.04-0.28), (ARR=0.45, 95 percent CI 0.22-0.94) respectively. Conclusion: The cumulative incidence of aspiration pneumonia among sampled patients was 23.06%. Vomiting, dysphagia, antibiotic treatment and Glasgow Comma Scale showed significant correlation with the acquiring of aspiration pneumonia. Therefore, we recommend health care providers to give special attention for patients with these risk factors to prevent aspiration pneumonia.

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“…The prevalence of intravenous thrombolysis is low in LMIC compared to HIC, which was 20% [ 43 ]. Intravenous thrombolysis is unavailable in most SSA secondary to cost issues [ 6 , 51 , 52 ]. Although acute IS treatment in the form of intravenous thrombolysis is available in our centre, our cohort's low rate of thrombolysis might be explained by the lack of stroke awareness in the community and the failure to recognise a stroke by health workers and the unavailability of brain imaging in peripheral referral facilities and thus delayed referrals.…”

Section: Discussionmentioning

confidence: 99%

“…In a study from Ghana, 35.0% of deaths were secondary to aspiration pneumonia [ 30 ]. In a recent study from Ethiopia, 66.0% of the in-hospital mortality was secondary to aspiration pneumonia, and 16.7% was secondary to raised ICP [ 51 ]. Similar findings were observed from the other two centres in Ethiopia [ 21 , 66 ].…”

Section: Discussionmentioning

confidence: 99%

The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study

Neshuku

Kirchner-Frankle

Nangolo

et al. 2023

Stroke Research and Treatment

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Background. Despite stroke being a leading cause of morbidity and mortality globally, there is a dearth of information on the burden and outcomes of stroke in sub-Saharan Africa and Namibia in particular. Methods. A hospital-based, retrospective cohort study was conducted to analyse non-electronic medical records of all consecutive stroke patients who were admitted to one of the highest tertiary-level hospitals in Namibia for 12 months (2019-2020). The primary outcome of the study was to establish the in-hospital mortality, stroke subtypes, and associated complications. Results. In total, 220 patients were included in the study, their mean age was 53 (SD13.8) years, and 55.5% were males. 61.0% had an ischaemic stroke (IS), and 39.0% had a haemorrhagic stroke (HS). The mean age was significantly lower in patients with HS vs. IS ( 48.2 ± 12.2 vs. 56.1 ± 13.3 , p < 0.001 ). Of the IS patients, the majority (29.0%) had total anterior circulation infarct (TACI), while in the HS group, 34.0% had basal ganglia haemorrhage with or without intraventricular extension. Hypertension ( p = 0.015 ), dyslipidaemia ( p = 0.001 ), alcohol consumption ( p = 0.022 ), and other cardiovascular diseases ( p = 0.007 ) were more prevalent in patients with IS compared to those with HS. The prevalence rate of intravenous thrombolysis was 2.2% in IS and use of intravenous antihypertensives in 25.9% of patients with HS than IS. The in-hospital mortality was 26.4% with complications such as raised ICP, aspiration pneumonia, hydrocephalus, and sepsis significantly high in those that died. Aspiration pneumonia (OR 2.79, 95% CI 1.63-4.76, p < 0.001 ) and increased ICP (OR 0.30, 95% CI 0.16-057, p < 0.001 ) were independent predictors of in-hospital mortality on the multivariate analysis. Conclusion. Our findings showed a younger mean age for stroke and mortality rate comparable to other low- to middle-income countries (LMICs). Hypertension and alcohol consumption were the main risk factors for both stroke subtypes, while aspiration pneumonia and raised intracranial pressure predicted in-hospital mortality.

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Clinical Characteristics, Treatment Outcomes, and its Predictors Among Hospitalized Stroke Patients in Ambo University Referral Hospital, West Ethiopia: A Retrospective Hospital-Based Study

Cited by 17 publications

References 41 publications

Epidemiological Profile and Issues of Acute Stroke Management in a Tertiary Care Hospital - A Prospective Longitudinal Study of Southern Coastal India.

Epidemiological Profile and Issues of Acute Stroke Management in a Tertiary Care Hospital - A Prospective Longitudinal Study of Southern Coastal India.

Incidence and Predictors of Aspiration Pneumonia among Stroke Patients in Western Amhara Region, North-West Ethiopia: A Retrospective Follow up Study

The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study

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