Risk Factors, Clinical Pattern and Outcome of Stroke in a Referral Hospital, Northwest Ethiopia

Abstract

Stroke is one of the commonest causes of morbidity and mortality among non-communicable diseases. Its occurrence has been significantly increasing in Sub Saharan Africa in the last couple of decades. Mortality has been shown to be higher in this area compared to developed countries. Yet, there is a big information gap about stroke in Ethiopia. This study aimed at describing the clinical pattern, risk factors and outcome of adult stroke patients admitted to university of Gondar hospital. Retrospective chart record analysis of adult patients with stroke who had Computerized tomography(CT) scan of the brain admitted to University of Gondar hospital medical wards from June 2010 to May 2013 was done. Relevant data including sociodemographics, risk factors, type of stroke and outcome were collected using a data extraction form. Data was entered and analyzed using Epi info7. Results: A total of 98 patients with a median age of 68 years (IQR: 60-76) and F:M ratio of 1.13:1 were analyzed. Ischemic stroke accounted for 69.4% of the cases. The median ages of patients with hemorrhagic and ischemic stroke were 60 and 70 years respectively (P=0.0027). Hypertension (55.9%), any type of structural heart disease (44.6%) and atrial fibrillation (28.7%) were the most commonly identified risk factors. Atrial fibrillation was more prevalent in ischemic stroke patients (34.3%) compared to hemorrhagic stroke (14.8%) (P= 0.049). In hospital mortality rate was 13% with median duration of hospital stay before death of 6 days. Respiratory failure secondary to aspiration pneumonia and increased intracranial pressure were the most common immediate causes of death. Conclusion: Even though ischemic stroke was the most common stroke subtype, the proportion of hemorrhagic stroke was higher compared to studies from the developed world. Appropriate screening and treatment of hypertension, structural heart disease and atrial fibrillation should be give due attention as they are the most commonly identified risk factors. Most deaths occurred early after admission due to stroke related acute complications with respiratory failure; as such an emergency stroke care unit capable of managing these complications can partially decrease the death rate.

Treatment Outcomes and Associated Factors among Hospitalized Stroke Patients at Shashemene Referral Hospital, Ethiopia

“…Ischemic stroke (48, 65.8%) was the most prevalent type of stroke in this study, which is lower than a study done in Northwest Ethiopia (69.4%) [11]. On the contrary, similar study done at St. Paul's Teaching Hospital showed hemorrhagic stroke was the most common type of stroke accounting for 61.3% of cases with majority of patients being in the 56–70 years age group [9].…”

Risk Factors Associated With Cerebro-Vascular Accident Ischemic Stroke In Young And Elderly Population.

“…patients. [12][13][14] From our study, the modifiable risk factors which were recorded are hypertension, cardio vascular disorder, Diabetes Mellitus, Dyslipidaemia and Life style related were Smoking, Alcohol consumption, Obesity which was comparable to the study conducted by MS Jahirul hoque choudhary et al (2015) [15][16][17][18] . From our study, one male Pediatric case was recorded.…”

In-Hospital Mortality among Ischemic Stroke Patients in Gondar University Hospital: A Retrospective Cohort Study

“…In Ethiopia, ischemic stroke has been identified as the sixth leading cause of death [8]. There are only few studies [9, 10] that assessed stroke outcomes in Ethiopia. These studies reported that the incidence of ischemic stroke is more common than hemorrhagic stroke and reported the overall mortality associated with stroke.…”