Prevalence of and characteristics associated with in-hospital mortality in a Ugandan neurology ward

Diaz, Monica M.; Hu, Xin; Fenton, Brenda T.; Kimuli, Ivan; Lee, Allison; Lindsey, Hayley; Bigelow, Jeffrey K; Maiser, Samuel; Altalib, Hamada; Sico, Jason J.

doi:10.1186/s12883-020-1627-5

Cited by 3 publications

(3 citation statements)

References 33 publications

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“…Cerebrovascular disease was the most common ND in the series with stroke accounting for 14%. Stroke is the second leading cause of death globally 1 , 12 and the leading neurological cause of hospital admissions and neurological cause of death in adults in SSA 5 , 7 . In the series cerebrovascular disease was significantly associated with HIV, OR 5.…”

Section: Discussionmentioning

confidence: 99%

“…The pattern of NDs in SSA differs from that reported in high income countries, with infections, in particular human immunodeficiency virus (HIV) being more prevalent and neurodegenerative diseases less common 3 – 6 . In SSA NDs typically account for 18–25% of adult medical hospital admissions, the majority of whom either die in hospital or are discharged with disability 3 , 5 , 7 . The most common causes of neurological admissions in adults are stroke, infections, paraplegia, neuropathies, coma and seizures 3 – 5 , 7 .…”

Section: Introductionmentioning

confidence: 99%

“…In SSA NDs typically account for 18–25% of adult medical hospital admissions, the majority of whom either die in hospital or are discharged with disability 3 , 5 , 7 . The most common causes of neurological admissions in adults are stroke, infections, paraplegia, neuropathies, coma and seizures 3 – 5 , 7 . The most common NDs reported in outpatients are seizures/epilepsy, headache, stroke sequelae, neuropathies, movement disorders and neurodegenerative disorders 8 – 11 .…”

Section: Introductionmentioning

confidence: 99%

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Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Howlett¹,

Urasa²,

Maro³

et al. 2022

Afr H. Sci.

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Background:The burden of neurological disorders is large and altered by the HIV epidemic. Objectives: We describe the pattern of neurological disorders and their association with HIV infection in adult patients attending a consultant hospital in Northern Tanzania. Methods: In this prospective cross-sectional study, we collected data on adult neurological referrals over a 6-year period between 2007-13. The odds of HIV infection, across neurological categories adjusted for age and sex, was calculated. Results: Of 2037 participants, 54.8% were male and 45.2% were female. The median age of participants was 43 years. The results for HIV screening were available for 992/2037 (48.7%) patients, of whom 306 (30.8%) were seropositive. The most frequent neurological disorders were cerebrovascular disease (19.9%), paraplegia (13.6%), and peripheral neuropathies (8%). Taken together CNS infection accounted for 278/2037 (13.6%). The adjusted odds (aOR) of HIV infection was highest amongst infections; brain abscesses (aOR 107, 95% CI 35.1-470.4) and meningitis/encephalitis (aOR 40.1, 95% CI 13.6-172.9), but also raised in cerebrovascular disease, paraplegia, peripheral neuropathies, cranial nerve palsies, seizures, cerebllar disorders, movement disorders, motor neuron disease andheadache. Conclusion: The main pattern of neurological disorders in Northern Tanzania is presented. The odds of HIV infection was highest in CNS infections and in a wide range of non-communicable neurological disorders. Keywords: Tanzania; neurological; disorder; neurological disease; hospital; HIV

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Howlett¹,

Urasa²,

Maro³

et al. 2022

Afr H. Sci.

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Carotid Doppler findings among patients admitted with stroke in two tertiary care facilities in Uganda: A Hospital-based Cross-sectional Study

Walubembe

Ssinabulya

Mubuuke

et al. 2023

Preprint

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Background Carotid Atherosclerotic Disease (CAD) Doppler findings including carotid artery stenosis, thickened intima media thickness, and high-risk atherosclerotic plaques are associated with increased risk of stroke and symptomatic cerebrovascular disease. However, few studies have explored these Doppler characteristics among stroke patients in Africa. This study, therefore, investigates these carotid artery Doppler characteristics among stroke patients in Uganda.Methods A hospital-based cross-sectional study of 95 stroke patients attending two national referral hospitals in Uganda between March and July 2022. Following the caption of their sociodemographic and clinical characteristics, they underwent Doppler sonography of the extracranial carotid arteries using a standard carotid Doppler protocol. Multivariate logistic regression was used to determine factors associated with abnormal carotid Doppler parameters (i.e., carotid intima-media thickness, carotid stenosis).Results The mean age of the study participants was 61 ± 13 years with 60% (57/95) of the participants being male. Most participants had an ischemic stroke (67%), hypertension (76.4%), and used alcohol (58.9%). The prevalence of significant carotid stenosis in participants with ischemic stroke was 12.5% (8/64) (i.e., 7.8% had severe carotid stenosis and 4.7% had moderate stenosis). The prevalence of high carotid intima media thickness (CIMT) and atherosclerotic plaques were 31.6% (30/95) and 26.3% (25/95), respectively. Most atherosclerotic plaques were echogenic. Age above 60 years (adjusted odds ratio [aOR] = 5.2, 95% Confidence Interval [CI]:1.97-14; p < 0.010), high low-density lipoprotein cholesterol (aOR = 4.2, 95% CI: 1.29–8.79; p = 0.013) increased the likelihood of having abnormal CIMT.Conclusion The burden of carotid atherosclerotic disease is increasing among stroke patients in Uganda. Large-scale epidemiological studies are needed to further profile the disease in high risk populations.

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Characteristics and direct causes of death in severely ill patients admitted to a neurology department

Lee,

Jeong,

Shin

et al. 2024

Front. Neurol.

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IntroductionThe study aimed to analyze the characteristics of patients admitted to the neurology department of a tertiary hospital who subsequently died, focusing on those with high disease severity.Materials and methodsWe conducted a retrospective cohort study of patients who died among those admitted to the neurology department of a regional tertiary hospital from 2013 to 2021. Clinical, radiological, and laboratory results of the included patients were collected, and their primary diagnoses, duration from time of admission to death, and direct causes of death were analyzed. Furthermore, the patients were categorized into subgroups based on sex (male and female), primary diagnosis (ischemic and non-ischemic stroke), and cancer diagnosis for comparative analysis.ResultsOf 187 deaths, the primary diagnoses were ischemic stroke (131 cases), seizures (19 cases), encephalitis and encephalopathy (18 cases), and other conditions (19 cases). The direct causes of death included ischemic stroke in 68 patients, sepsis in 33, cerebral hemorrhage in 19, pneumonia in 15, acute kidney injury in nine, status epilepticus in seven, and other causes in 36. Pneumonia, cerebral hemorrhage, acute kidney injury, and status epilepticus were the more prevalent direct causes of death in men, whereas ischemic stroke and sepsis were more prevalent in women. Additionally, sepsis, pneumonia, acute kidney injury, and status epilepticus, as direct causes of death, were significantly higher among patients with a primary diagnosis of non-ischemic stroke than among those with a primary diagnosis of ischemic stroke. Furthermore, there were differences in some pre-existing diseases and laboratory findings when comparing between the cancer group and the non-cancer group.DiscussionIschemic stroke was the primary diagnosis and direct cause of death in a high proportion of patients. Other noteworthy direct causes of death were cerebral hemorrhage and infections such as sepsis and pneumonia. Based on these findings, the characteristics and prognoses of patients admitted to neurology departments can be predicted and used for management.

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Prevalence of and characteristics associated with in-hospital mortality in a Ugandan neurology ward

Cited by 3 publications

References 33 publications

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Neurological disorders in Northern Tanzania: A 6-year prospective hospital-based case series

Carotid Doppler findings among patients admitted with stroke in two tertiary care facilities in Uganda: A Hospital-based Cross-sectional Study

Characteristics and direct causes of death in severely ill patients admitted to a neurology department

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