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.
| Published in | Clinical Medicine Research (Volume 4, Issue 6) |
| DOI | 10.11648/j.cmr.20150406.13 |
| Page(s) | 182-188 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2015. Published by Science Publishing Group |
Cerebrovascular Accident, University of Gondar Hospital, in Hospital Mortality
| [1] | Feigin, V.L., et al., Stroke epidemiology: a review of population-based studies of incidence, prevalence, and case-fatality in the late 20th century. Lancet neurology, 2003. 2(1): p. 43-53. |
| [2] | Connor, M.D., et al., Prevalence of stroke survivors in rural South Africa: results from the Southern Africa Stroke Prevention Initiative (SASPI) Agincourt field site. Stroke, 2004. 35(3): p. 627-32. |
| [3] | Balogou, A.A., A. Doh, and K.E. Grunitzky, [Neurological disorders and endemic goiter: comparative analysis of 2 provinces in Togo]. Bull Soc Pathol Exot, 2001. 94(5): p. 406-10. |
| [4] | Walker, R., et al., Stroke incidence in rural and urban Tanzania: a prospective, community-based study. The Lancet Neurology, 2010. 9(8): p. 786-792. |
| [5] | WHO. WHO Global InfoBase. 2004 [cited 2013 July 20]; Available from: http://www.who.int/infobase |
| [6] | Matenga, J., Stroke incidence rates among black residents of Harare-a prospective community-based study. SOUTH AFRICAN MEDICAL JOURNAL-CAPE TOWN-MEDICAL ASSOCIATION OF SOUTH AFRICA-, 1997. 87: p. 606-608. |
| [7] | Osuntokun, B., et al., Neurological disorders in Nigerian Africans: a community‐based study. Acta neurologica scandinavica, 1987. 75(1): p. 13-21. |
| [8] | Owolabi, M.O., et al., The burden of stroke in Africa: a glance at the present and a glimpse into the future: review article. 2015. |
| [9] | Maredza, M., M.Y. Bertram, and S.M. Tollman, Disease burden of stroke in rural South Africa: an estimate of incidence, mortality and disability adjusted life years. BMC neurology, 2015. 15(1): p. 54. |
| [10] | Strong, K., C. Mathers, and R. Bonita, Preventing stroke: saving lives around the world. Lancet Neurol, 2007. 6(2): p. 182-7. |
| [11] | Asefa, G. and S. Meseret, CT and clinical correlation of stroke diagnosis, pattern and clinical outcome among stroke patients visting Tikur Anbessa Hospital. Ethiop Med J, 2010. 48(2): p. 117-22. |
| [12] | Jowi, J. and P. Mativo, Pathological Sub-Types, Risk Factors And Outcome Of Stroke At The Nairobi Hospital, Kenya. East African Medical Journal, 2008. 85(12). |
| [13] | Zenebe, G., M. Alemayehu, and J. Asmera, Characteristics and outcomes of stroke at Tikur Anbessa Teaching Hospital, Ethiopia. Ethiop Med J, 2005. 43(4): p. 251-9. |
| [14] | Kengne, A.P. and C.S. Anderson, The neglected burden of stroke in Sub-Saharan Africa. Int J Stroke, 2006. 1(4): p. 180-90. |
| [15] | Deresse, B. and D. Shaweno, Epidemiology and in-hospital outcome of stroke in South Ethiopia. Journal of the neurological sciences, 2015. 355(1): p. 138-142. |
| [16] | Alemayehu, B. and K. Oli, Stroke Admission to Tikur Anbassa Teaching Hospital: With Emphasis on Stroke in the Young. Ethiopian Journal of Health Development, 2002. 16(3): p. 309-315. |
| [17] | Joubert, J., The MEDUNSA Stroke Data Bank. An analysis of 304 patients seen between 1986 and 1987. S Afr Med J, 1991. 80(11-12): p. 567-70. |
| [18] | Matenga, J., I. Kitai, and L. Levy, Strokes among black people in Harare, Zimbabwe: results of computed tomography and associated risk factors. Br Med J, 1986. 292(6536): p. 1649-51. |
| [19] | Tekle-Haimanot, R., et al., Community-based study of neurological disorders in rural central Ethiopia. Neuroepidemiology, 1990. 9(5): p. 263-77. |
| [20] | Kebede, B., Stroke Admissions to Tikur Anbessa Hospital , With Emphasis on Stroke in The Young Ethio.J. Health. Dev., 2002. 16(3): p. 309-315. |
| [21] | Nyame, P.K., K.B. Jumah, and S. Adjei, Computerised tomographic scan of the head in evaluation of stroke in Ghanaians. East Afr Med J, 1998. 75(11): p. 637-9. |
| [22] | Walker, R.W., et al., Mortality and recovery after stroke in the Gambia. Stroke, 2003. 34(7): p. 1604-9. |
| [23] | Lamassa, M., et al., Characteristics, Outcome, and Care of Stroke Associated With Atrial Fibrillation in Europe Data From a Multicenter Multinational Hospital–Based Registry (The European Community Stroke Project). Stroke, 2001. 32(2): p. 392-398. |
| [24] | Jorgensen, H.S., et al., Acute stroke with atrial fibrillation. The Copenhagen Stroke Study. Stroke, 1996. 27(10): p. 1765-9. |
| [25] | Sandercock, P., et al., Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project). BMJ, 1992. 305(6867): p. 1460-5. |
| [26] | Alemayehu, C.M. and S.K. Birhanesilasie, Assessment of stoke patients: Occurrence of unusually high number of haemorrhagic stroke cases in Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. |
| [27] | Atadzhanov, M., et al., Stroke Characteristics and Outcomes of Adult Patients Admitted to the University Teaching Hospital, Lusaka, Zambia. Open General and Internal Medicine Journal, 2012. 5: p. 3-8. |
| [28] | Desalu, O.O., et al., A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria. Ann Afr Med, 2011. 10(2): p. 80-5. |
| [29] | Sridharan, S.E., et al., Incidence, types, risk factors, and outcome of stroke in a developing country the trivandrum stroke registry. Stroke, 2009. 40(4): p. 1212-1218. |
| [30] | Mlay, M. and M. Bakari, The prevalence of HIV among patients admitted with stroke at the Muhimbili National Hospital, Dar es Salaam, Tanzania. Tanzania Journal of Health Research, 2010. 12(2): p. 105-113. |
| [31] | Chow, F.C., et al., Comparison of Ischemic Stroke Incidence in HIV-Infected and Non–HIV-Infected Patients in a US Health Care System. JAIDS Journal of Acquired Immune Deficiency Syndromes, 2012. 60(4): p. 351-358. |
APA Style
Ermias Shenkutie Greffie, Tadesse Mitiku, Seid Getahun. (2015). Risk Factors, Clinical Pattern and Outcome of Stroke in a Referral Hospital, Northwest Ethiopia. Clinical Medicine Research, 4(6), 182-188. https://doi.org/10.11648/j.cmr.20150406.13
ACS Style
Ermias Shenkutie Greffie; Tadesse Mitiku; Seid Getahun. Risk Factors, Clinical Pattern and Outcome of Stroke in a Referral Hospital, Northwest Ethiopia. Clin. Med. Res. 2015, 4(6), 182-188. doi: 10.11648/j.cmr.20150406.13
AMA Style
Ermias Shenkutie Greffie, Tadesse Mitiku, Seid Getahun. Risk Factors, Clinical Pattern and Outcome of Stroke in a Referral Hospital, Northwest Ethiopia. Clin Med Res. 2015;4(6):182-188. doi: 10.11648/j.cmr.20150406.13
Share This Article
Twitter
Linked In
Facebook
Copy
Download@article{10.11648/j.cmr.20150406.13,
author = {Ermias Shenkutie Greffie and Tadesse Mitiku and Seid Getahun},
title = {Risk Factors, Clinical Pattern and Outcome of Stroke in a Referral Hospital, Northwest Ethiopia},
journal = {Clinical Medicine Research},
volume = {4},
number = {6},
pages = {182-188},
doi = {10.11648/j.cmr.20150406.13},
url = {https://doi.org/10.11648/j.cmr.20150406.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20150406.13},
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.},
year = {2015}
}
TY - JOUR T1 - Risk Factors, Clinical Pattern and Outcome of Stroke in a Referral Hospital, Northwest Ethiopia AU - Ermias Shenkutie Greffie AU - Tadesse Mitiku AU - Seid Getahun Y1 - 2015/10/30 PY - 2015 N1 - https://doi.org/10.11648/j.cmr.20150406.13 DO - 10.11648/j.cmr.20150406.13 T2 - Clinical Medicine Research JF - Clinical Medicine Research JO - Clinical Medicine Research SP - 182 EP - 188 PB - Science Publishing Group SN - 2326-9057 UR - https://doi.org/10.11648/j.cmr.20150406.13 AB - 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. VL - 4 IS - 6 ER -
Email: