A prospective cohort study of stroke characteristics, care, and mortality in a hospital stroke registry in Vietnam

Tirschwell, David; Ton, Thanh G.N.; Ly, Kiet A.; Ngo, Quang Van; Vo, Tung T; Pham, Chien H.; Longstreth, W. T.; Fitzpatrick, Annette L.

doi:10.1186/1471-2377-12-150

Cited by 42 publications

(39 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neurological disorders are severely disabling and patients are often admitted to tertiary care hospitals [ 4 , 8 , 9 ]. Moreover, acute NDs such as stroke, intensive-care-unit-acquired weakness, delirium, epilepsy and epileptic seizures are associated with high hospital mortality [ 10 - 14 ]. Although the trend towards hospital death due to dementia is reversing, two of five patients with dementia died in hospitals [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

Hospital Mortality Among Elderly Patients Admitted With Neurological Disorders Was Not Predicted by any Particular Diagnosis in a Tertiary Medical Center

Bacellar

Assis

Pedreira

et al. 2018

TONEUJ

View full text Add to dashboard Cite

Background:Neurological disorders (NDs) are associated with high hospital mortality. We aimed to identify predictors of hospital mortality among elderly inpatients with NDs.Methods:Patients aged ≥60 years admitted to the hospital between January 1, 2009 and December 31, 2010 with acute NDs, chronic NDs as underpinnings of acute clinical disorders, and neurological complications of other diseases were studied. We analyzed demographic data, NDs, and comorbidities as independent predictors of hospital mortality. Logistic regression was performed for multivariable analysis.Results:Overall, 1540 NDs and 2679 comorbidities were identified among 798 inpatients aged ≥ 60 years (mean 75.8±9.1). Of these, 54.5% were female. Diagnostic frequency of NDs ranged between 0.3% and 50.8%. Diagnostic frequency of comorbidities ranged from 5.6% to 84.5%. Comorbidities varied from 0 to 9 per patient (90% of patients had ≥2 comorbidities), mean 3.2±1.47(CI, 3.1-3.3). Patients with multimorbidities presented with a mean of 4.7±1.7 morbidities per patient. Each ND and comorbidity were associated with high hospital mortality, producing narrow ranges between the lowest and highest incidences of death (hospital mortality = 18%) (95% CI, 15%-21%). After multivariable analysis, advanced age (P<0.001) and low socioeconomic status (P=0.003) were recognized as predictors of mortality, totaling 9% of the variables associated with hospital mortality.Conclusion:Neither a particular ND nor an individual comorbidity predicted hospital mortality. Age and low socioeconomic class accounted for 9% of predictors. We suggest evaluating whether functional, cognitive, or comorbidity scores will improve the risk model of hospital mortality in elderly patients admitted with ND.

show abstract

Section: Introductionmentioning

confidence: 99%

Hospital Mortality Among Elderly Patients Admitted With Neurological Disorders Was Not Predicted by any Particular Diagnosis in a Tertiary Medical Center

Bacellar

Assis

Pedreira

et al. 2018

TONEUJ

View full text Add to dashboard Cite

show abstract

“…From the total stroke patients admitted, 91(78.4%) patients were discharged alive and around one fifth (21.6%) of them experienced in hospital stroke mortality. From those discharged alive, more than half (57.8%) of the patients were discharged with improvement which was lower as compared to study by Masood et al in Pakistan (91%) [35], Jowi et al in kenya (93.8%) [36] and Tirschwell etal in Vietnam (65.8%) [16], but higher than study done by Gebremariam etal in Ethiopia (47.9%) [37]. On the other hand, our finding was comparable with study done in Ethiopia by Greffie etal in which 59.18% of the patients were discharged with improvement [10].…”

Section: Discussionmentioning

confidence: 65%

Burden, clinical outcomes and predictors of time to in hospital mortality among adult patients admitted to stroke unit of Jimma university medical center: a prospective cohort study

Fekadu

Chelkeba

Kebede³

2019

Preprint

View full text Add to dashboard Cite

Background: The global burden of stroke epidemiology is changing rapidly. Over the 1990–2013 periods, there was a significant increase in the absolute number of deaths and incident events of stroke. The burden of stroke varies in Ethiopia between regions and over time. Hence, this study was aimed to assess the burden, clinical outcomes and predictors of time to in hospital mortality among stroke patients. Methods: A prospective cohort study was carried at stroke unit of Jimma University Medical Center (JUMC) from March 10- July 10, 2017. The outcome of interest was mortality and time to death. Data was analyzed using SPSS version 20. Multivariable Cox regression was used to identify the predictors of in hospital mortality and time to death from hospital arrival. Predictor variables with P< 0.05 was considered statistically significant. Results: A total of 116 eligible stroke patients were followed over 4 months. The mean age of patients was 55.1+14.0 years and males comprised of 73 (62.9%). Stroke accounted for 16.5 % of total medical admissions. Among the 116 patients with stroke, 91 (78.4%) were discharged alive making in hospital mortality of rate of 25 (21.6%). The median time of in hospital mortality and length of hospital stay after admission of the patients were 4.38 days and 9.21 days, respectively. The prominent suspected immediate cause for in hospital mortality was increased intracranial pressure in 17 (68.0%) followed by respiratory failure secondary to aspiration pneumonia in 11 (44.0%) patients. Brain edema (AHR: 6.27, 95% CI: 2.50-15.76), urine incontinence (AHR: 3.48, 95% CI: 1.48-8.17), National Institute of Health Stroke Scale (NIHSS) >13 during hospital arrival (AHR: 22.58, 95% CI: 2.95-172.56) and diagnosis of stroke clinically alone (AHR: 4.96, 95% CI: 1.96-12.54) were the independent predictors of time to in hospital mortality. Conclusions: The mortality rate of stroke in this setup was comparable with other low- and middle-income countries (LMICs). There is an urgent need to establish well equipped and staffed stroke units in the country in addition to strengthen the already existing on. Furthermore, future work must be designed to identify the barriers to improve stroke outcomes and recovery.

show abstract

“…The incidence of mortality following stroke was sourced from Trishwell 2012 [34] and Kiyohara 2003 [35].…”

Section: Clinical Events and Epidemiologymentioning

confidence: 99%

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Taylor¹,

Hoek²,

Deltetto

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Dietary sodium reduction is recommended to reduce the burden of cardiovascular disease. In Vietnam food products including salt, fish sauce and bot canh contribute to ~70% of dietary sodium intake. Reduced sodium versions of these products can be produced by replacing some of the sodium chloride with potassium chloride. We aimed to assess the cost-effectiveness of three alternative approaches to introducing reduced sodium products onto the market with a view to lowering population sodium intake in Vietnam.Methods The three salt substitution strategies included voluntary, subsidised and regulatory approaches targeting salt, fish sauce and bot canh products. Costs were modelled using the WHO-CHOICE methodology. A Markov cohort model was developed to evaluate the cost-effectiveness of each strategy versus no intervention from the government perspective. The model linked each intervention strategy to assumed changes in levels of sodium intake and then to systolic blood pressure. Changes in SBP were linked to a probability of ischaemic heart disease or stroke. The model followed people over their lifetime to assess average costs and quality adjusted life years (QALYs) gained for each strategy. Results The voluntary salt substitution strategy was assumed to require no investment by government. Following ramp up (years 6+), the average annual costs for the subsidised and regulatory strategies were 21,808,968,902 ₫ (US$ 977,354) and 12,949,953,247 ₫ (US$ 580,410) respectively. Relative to no intervention, all three salt substitution strategies were found to be cost-effective. Cost savings were driven by reductions in strokes (32,595; 768,384; 2,366,480) and IHD events (22,830; 537,157; 1,648,590) for the voluntary, subsidised & regulatory strategies, respectively. The voluntary strategy was least cost-effective (-3,445 ₫ US$ -0.15; 0.009 QALYs gained) followed by the subsidised strategy (-43,189 ₫ US$ -1.86; 0.022 QALYs gained) and the regulatory strategy delivered the highest cost savings and health gains (-243,530 ₫ US$ -10.49; 0.074 QALYs gained). Conclusion This research shows that all three modelled salt substitution strategies would be good value for money relative to no intervention in Vietnam. The subsidised alternative would require the highest level of government investment, however the implementation costs will be exceeded by healthcare savings assuming a reasonable time horizon is considered.

show abstract

A prospective cohort study of stroke characteristics, care, and mortality in a hospital stroke registry in Vietnam

Cited by 42 publications

References 27 publications

Hospital Mortality Among Elderly Patients Admitted With Neurological Disorders Was Not Predicted by any Particular Diagnosis in a Tertiary Medical Center

Hospital Mortality Among Elderly Patients Admitted With Neurological Disorders Was Not Predicted by any Particular Diagnosis in a Tertiary Medical Center

Burden, clinical outcomes and predictors of time to in hospital mortality among adult patients admitted to stroke unit of Jimma university medical center: a prospective cohort study

The cost-effectiveness of government actions to reduce sodium intake through salt substitutes in Vietnam

Contact Info

Product

Resources

About