Determinants of in-hospital Mortality Among Adult Stroke Patients Admitted to Public Hospital of Shashamane City West Arsi, Oromia, Ethiopia. A Two Year Unmatched Case-control Study

Abstract

Background: Now-day’s, stroke is becoming a public health problem in developing countries as well, with huge consequences in terms of loss of productivity, premature death and long-term disability. In an effort to improve the standard of stroke care, we investigated the factors that increase the risk of in-hospital mortality. Objective: To identify determinants of in-hospital mortality among adult stroke patients admitted to public hospitals in Shashamane city, Oromia Ethiopia, 2024. Design: a Facility-based unmatched case-control study was conducted from January 30, 2021 to January 30, 2023. Setting: This study was conducted in Shashamane city, Oromia, Ethiopia. Participants: Medical records of 204 (66 cases and 138 controls) stroke patient admitted at public hospitals of Shashamane town were included. Methods: Data from patients' medical records were collected using a standardized checklist. Epi Data version 4.6 was employed for data entry, while Statistical Package for the Social Sciences (SPSS) version 26 facilitated analysis. Univariate and multivariable binary logistic regression was done and a p-value of less than 0.05 was used to declare significance. Adjusted Odds Ratio (AOR) with 95% confidence interval was used to indicate the strength of association between the variables Results: aspiration pneumonia(AOR=6.2, 95%, CI=1.93 – 19.95), sepsis (AOR=13.44, 95%, CI=4.41– 40.9), hemorrhagic stroke (AOR=6.91, 95%, CI=2.12 – 22.26), increased intracranial pressure (AOR=3.61, 95%, CI=1.2 – 10.82) and patients with severe Glasgow Coma Scale (3-8) (AOR=8.27, 95%, CI=1.88 – 36.38) were statistically significant and predictors of mortality. Conclusion: aspiration pneumonia, sepsis, hemorrhagic stroke, increased intracranial pressure, and moderate Glasgow Coma Scale were determinants of in-hospital mortality. Therefore, early identification and treatment of complications along with strict follow-up are required to reduce in-hospital stroke mortality.