The Short-Term and Medium-Term Prognosis of a Stroke and the Factors of Poor Prognosis in Liberville

Abstract

Objectives: was to determine the factors influencing stroke prognosis in Libreville. Methods: This was a multicenter study prospective with a descriptive and analytical focus carried out from March 1st to July 31, 2014. Recruitment was systematic and exhaustive. The data collected was processed and analyzed using Epi-Info 3.3.5 software. Results: This study involved 66 patients including 27 male (40.9%) and 39 female (59.1%). Mean age was 55.1 +/− 15.3 years, mostly female. There were 57.5% ischemic stroke, 42.5% hemorrhagic stroke. The mean NIHSS was 7.8 +/− 6.6 at admission. Intrahospital stroke mortality rates at 1 and 3 months were 7.6% and 9.1% respectively, ranging from 18.2% to 31.8%. The following factors were identified as associated with death at 1 month: age, high NIHSS at admission, high blood pressure, leukocytosis, hyperthermia and delay in admission. As for functional outcome, patients were relatively autonomous at discharge and factors associated with poor functional outcome (Rankin < 2) at 1 month were: age, high NIHSS, blood glucose and length of hospital stay. Factors associated with mortality and follow-up at 3 months could not be assessed due to 9 lost to follow-up (living or dead). Conclusion: This study highlights many factors influencing prognosis of stroke. The poor prognostic factors were age, high NIHSS at admission, high blood pressure, hyperthermia, blood glucose, leukocytosis, delay in admission and length of hospital stay. Addressing these factors in the acute phase management strategies may improve the prognosis of stroke patients in Gabon.