Prognostic Signification of Admission Hyperglycemia among Acute Stroke Patients in Intensive Care Units in Kinshasa, the Democratic Republic of the Congo

Tshituta, Josée K.; Lepira, François Bompeka; Kajingulu, François P.; Makulo, J.R.; Sumaili, Ernest Kiswaya; Akilimali, Pierre; Nkodila, Aliocha; Mbuyi, Freddy M.; Masewu, A.-I.; Mutombo, Stéphane; Amisi, Eric Bibonge; Ilunga, Jean Pierre Mwena; Mbombo, Wilfrid B.; Mukuna, Patrick; Kilembe, Adolphe M

doi:10.4236/wjcd.2019.99060

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Our series found that hyperglycaemia (>180mg/dl in 23.6%) was not associated with poor outcome, contrary to the work of Tshituta [23]. Treatment of haemorrhagic stroke was solely medical, as Anna Johnson had also emphasised [24].…”

Section: Discussioncontrasting

confidence: 56%

Factors Associated With Stroke Mortality in an Urban-Rural Environment: The Case of the MONKOLE Hospital Centre

Likinda,

Mbuyi,

Bukasa

et al. 2023

Neuro Neurosci

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Background: Stroke is a fatal disease, and knowledge of the factors associated with this mortality in different environments is necessary in order to take appropriate action. This article presents data from a hospital located in an urban-rural setting in Kinshasa: The Monkole hospital centre. Methods: This is a cross-sectional study conducted at Monkole hospital Centre from 01/01/2020 to 31/01/2023 in all patients with a confirmed diagnosis of stroke admitted to intensive care, emergency or internal medicine. Sociodemographic, clinical, paraclinical, therapeutic and outcome data were collected from hospital registers and patient records. Student's t, Anova, Chi-squared or Fischer's exact tests and logistic regression were performed with SPSS 25.0 with p less than 5%. Ethical principles were respected. Results: Of 3,629 patients admitted during the study period, 148 (4%) were admitted for stroke. The mean age was 62.6 years and the predominant sex was male. 51.4% of patients were admitted from home, with the following comorbidities: arterial hypertension, diabetes mellitus and embolism-induced heart disease. Frequent reasons for consultation were: disturbed consciousness, increased blood pressure and convulsions. Frequent physical signs were: disturbed consciousness, increased blood pressure, neurological deficit and pupillary abnormalities. The average time to hospital was 13.6 ± 8.2 hours. The accident was ischaemic in 70.3% and haemorrhagic in 29.7%. Treatment was medical in 100% of cases, with no thrombolysis. Mortality was 11.5% and 36.5% of survivors had moderate to severe functional disability. Advanced age (OR 2.34, 95% CI 1.36-4.04), hypertension (OR 2.19, 95% CI 1.24-3.88) and low socio-economic status (OR 1.81, 95% CI 1.02-3.21) were associated with mortality. Conclusion: Mortality in this series was 11.5%, associated with advanced age, hypertension and low socioeconomic status. Controlling blood pressure and improving living conditions could reduce this mortality

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Section: Discussioncontrasting

confidence: 56%

Factors Associated With Stroke Mortality in an Urban-Rural Environment: The Case of the MONKOLE Hospital Centre

Likinda,

Mbuyi,

Bukasa

et al. 2023

Neuro Neurosci

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“…A total of ten (10) significant risk factors were identified. These were low Glasgow Coma Score <8 [24,28,34,35,48,50,58,61,63,73,95,96,100,105], high (�10) National Institute Health Stroke Scale score [40,57,58,60,78,82,87,92,114], aspiration pneumonia [27,63,73,82,87,88,90,95,100,114], hemorrhagic stroke [29,40,92,95,105], brain edema/ intra-cranial pressure [28,34,88,114], hyperglycemia [35,40,50], untyped stroke (stroke diagnosis not confirmed by neuroimaging) [28,34,95], recurrent stroke [29,…”

Section: Risk Factors For 30-day In-hospital Stroke Case Fatalitymentioning

confidence: 99%

30-day in-hospital stroke case fatality and significant risk factors in sub-Saharan–Africa: A systematic review and meta-analysis

Ackah,

Ameyaw,

Appiah

et al. 2024

PLOS Glob Public Health

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Existing studies investigating 30-day in-hospital stroke case fatality rates in sub-Saharan Africa have produced varying results, underscoring the significance of obtaining precise and reliable estimations for this indicator. Consequently, this study aimed to conduct a systematic review and update of the current scientific evidence regarding 30-day in-hospital stroke case fatality and associated risk factors in sub-Saharan Africa. Medline/PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), APA PsycNet (encompassing PsycINFO and PsychArticle), Google Scholar, and Africa Journal Online (AJOL) were systematically searched to identify potentially relevant articles. Two independent assessors extracted the data from the eligible studies using a pre-tested and standardized excel spreadsheet. Outcomes were 30-day in-hospital stroke case fatality and associated risk factors. Data was pooled using random effects model. Ninety-three (93) studies involving 42,057 participants were included. The overall stroke case fatality rate was 27% [25%-29%]. Subgroup analysis revealed 24% [21%-28%], 25% [21%-28%], 29% [25%-32%] and 31% [20%-43%] stroke case fatality rates in East Africa, Southern Africa, West Africa, and Central Africa respectively. Stroke severity, stroke type, untyped stroke, and post-stroke complications were identified as risk factors. The most prevalent risk factors were low (<8) Glasgow Coma Scale score, high (≥10) National Institute Health Stroke Scale score, aspiration pneumonia, hemorrhagic stroke, brain edema/intra-cranial pressure, hyperglycemia, untyped stroke (stroke diagnosis not confirmed by neuroimaging), recurrent stroke and fever. The findings indicate that one in every four in-hospital people with stroke in sub-Saharan Africa dies within 30 days of admission. Importantly, the identified risk factors are mostly modifiable and preventable, highlighting the need for context-driven health policies, clinical guidelines, and treatments targeting these factors.

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“…Hyperglycaemia (HG) during acute ischemic stroke (AIS), which is defined as random blood glucose > 7.8 mmol/L during the acute ischemic attack was not only associated with poor outcomes but also associated with SAP [ 13 , 14 ]. HG was known to reduce the bactericidal ability of leukocytes, increasing the likelihood of pulmonary infection [ 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Stroke-Associated Pneumonia and Its Predictors Among Hyperglycaemia Patients During Acute Ischemic Stroke

Elhefnawy,

Nazifah Sidek,

Maisharah Sheikh Ghadzi

et al. 2024

Cureus

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Background: Hyperglycaemia (HG) during an acute ischemic stroke (AIS) is not only associated with unfavourable functional outcomes but also associated with stroke-associated pneumonia (SAP). This study aimed to determine the prevalence of SAP among Malaysian patients with AIS and the predictors of SAP among patients with HG during AIS. Methods: This is a retrospective cross-sectional study that included patients with AIS admitted to Hospital Sultanah Nur Zahirah, Malaysia from 2017 to 2020. SAP was defined as infection with pneumonia during the first seven days after IS. HG was defined as a blood glucose level > 7.8 mmol/L within 72 h after admission. Patients with SAP were divided into two groups according to HG status. Multivariate logistic regression analysis was performed using SPSS software, version 22 (IBM Corp., Armonk, NY) to identify SAP predictors among patients with HG. Kaplan-Meier log-rank test was used to compare the survival rate from unfavourable functional outcomes between hyperglycaemic patients with and without SAP. Results: Among 412 patients with AIS, 69 (16.74%) had SAP. The prevalence of SAP among patients with HG and normoglycemia during AIS was 20.98%, and 10.65%, respectively. Age above 60 years, leucocytosis, and National Institute of Health Stroke Scale (NIHSS) > 14 on admission were independent predictors of SAP with aOR of 2.08 (95% CI;1.01-4.30), 2.83 (95% CI; 1.41-5.67), and 3.67 (95% CI; 1.53-8.80), respectively. No significant difference in unfavourable functional outcomes survival was found among patients with and without SAP ( p = 0.653). Conclusion: This study demonstrated the prevalence of SAP was higher among patients with HG compared to normoglycemia during AIS. The patient being old, leucocytosis and severe stroke upon admission predict the occurrence of SAP among patients with HG during AIS.

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Prognostic Signification of Admission Hyperglycemia among Acute Stroke Patients in Intensive Care Units in Kinshasa, the Democratic Republic of the Congo

Cited by 3 publications

References 29 publications

Factors Associated With Stroke Mortality in an Urban-Rural Environment: The Case of the MONKOLE Hospital Centre

Factors Associated With Stroke Mortality in an Urban-Rural Environment: The Case of the MONKOLE Hospital Centre

30-day in-hospital stroke case fatality and significant risk factors in sub-Saharan–Africa: A systematic review and meta-analysis

Prevalence of Stroke-Associated Pneumonia and Its Predictors Among Hyperglycaemia Patients During Acute Ischemic Stroke

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