Magnitude, risk factors and outcomes of stroke at Debre Markos Referral Hospital, Northwest Ethiopia: a retrospective observational study

Mulugeta, Henok; Yehuala, Amare; Haile, Dessalegn; Mekonnen, Nakachew; Dessie, Getenet; Kassa, Getachew Mullu; Kassa, Zerihun Shimelis

doi:10.1186/s41983-020-00173-4

Cited by 29 publications

(42 citation statements)

References 42 publications

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“…In this study, the overall incidence of stroke was 3.15% and the rate was lower than the report of different studies conducted in Ethiopia like 19.3%, 21 7.7%, 22 7.5%, 23 and 7.2%. 24 Lack of the diagnostic technology such as MRI or CT scan and manual registration and management system of records in the study hospital might have an association with lower rates of stroke patients.…”

Section: Discussioncontrasting

confidence: 71%

“…Likewise, several studies reported that ischemic stroke was the dominant subtype of stroke. 21 – 24 , 26 , 27 , 29 – 33 However, some studies reported that hemorrhagic stroke is the dominant subtype of the stroke in other parts of Ethiopia. 12 , 25 , 12 Patients in this study were more likely to have risk factors associated with ischemic stroke and this might be a reason for the variation.…”

Section: Discussionmentioning

confidence: 99%

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Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia

Agazhe¹,

Eshetu²,

Arsicha³

et al. 2021

SAGE Open Medicine

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Introduction: In the current days, stroke has become one of the common reasons for admission in many health care setups and becoming an alarming public health problem in Ethiopia. Hence, this study aimed to assess the incidence and associated factors of stroke among patients admitted to the medical wards in Yirgalem hospital. Methods: An institution-based retrospective cross-sectional study design was carried out from 01 January 2017, to 30 December 2019. Admitted adult patients’ medical charts were used to collect all required information using structured checklists. Data were analyzed using statistical package for social sciences (SPSS) version 20 software, and a p value < 0.05 was accepted as statistically significant. Result: From a total of 3016 admitted patients, the incidence of stroke was 3.15% (n = 95). Of the 95 stroke cases, 58.9% were males and 69.5% of them were urban dwellers. 62.1% (59/95) of the stroke patients had an ischemic stroke, whereas 37.9% (36/95) had a hemorrhagic stroke. Patients with age ⩾ 65 years, smokers, hypertension, and type-II diabetes had significantly higher ischemic stroke when compared to patients with hemorrhagic stroke (62.7% vs 30.5%, p = 0.008), (49.1% vs 11.1%, p ⩽ 0.0001), and (71.2%vs 13.9%, p < 0.0001), respectively. While patients with hypertension had a significantly higher rate of hemorrhagic stroke when compared to patients with ischemic stroke (88.9% vs 61%, p = 0.003). Conclusion: The majority of stroke patients had cardiovascular problems and hypertension. More than 44% and 34.7% of them had a history of alcoholism and smoking. Therefore, proper management of hypertension, lifestyle modification, early screening and management of strok risks and avoiding risk-full personal behaviors like smoking and alcoholism are important tools to limit or prevent stroke-related morbidity and mortality.

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia

Agazhe¹,

Eshetu²,

Arsicha³

et al. 2021

SAGE Open Medicine

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“…11 , 21 , 24 , 34 The sample size of the included studies was ranged from 36 to 1054. 13 , 36 Of the total studies, most of them (15 studies) were conducted in Eastern Africa 15 , 16 , 19 , 20 , 22 – 24 , 26 – 29 , 31 , 32 , 34 , 37 and eight of them were in Western Africa 12 – 14 , 21 , 30 , 33 , 35 , 36 and the remaining four studies were conducted in Southern Africa 11 , 17 , 18 , 25 ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“… 8 , 10 Several studies were conducted to evaluate the in-hospital mortality rate from acute stroke in sub-Saharan Africa. 11 – 37 However, the mortality rate has not been summarized to reflect the overall in-hospital mortality rate in the region. Hence, this systematic review and meta-analysis aimed to obtain more robust evidence on stroke treatment outcomes from the existing literature in sub-Saharan Africa countries.…”

Section: Introductionmentioning

confidence: 99%

In-hospital mortality and its predictors among stroke patients in sub-Saharan Africa: A systemic review and meta-analysis

et al. 2021

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Objective: To assess the in-hospital mortality from acute stroke and its predictors in sub-Saharan Africa. Method: The literature search was conducted in the databases of PubMed/Medline, Embase, CINAHL, and Google Scholar. The retrieved studies were screened by titles and abstracts, and then full texts were assessed for eligibility. The methodological quality of the included studies was assessed using the Joanna Briggs Institute’s critical appraisal checklist. The publication bias was assessed using the funnel plot asymmetry and the Egger tests. Data were analyzed using Stata software version 15.0 in a random-effect model. Result: A total of 27 studies with a total sample size of 6331 were included in this systematic review and meta-analysis. The pooled estimated prevalence of in-hospital mortality due to stroke was 22% (95% confidence interval = 0.17–0.27). Stroke mortality in Western Africa (37%, 95% confidence interval = 0.24–0.50) was higher than in Eastern Africa (15%, 95% confidence interval = 0.12–0.19) and Southern Africa (18%, 95% confidence interval = 0.06–0.19). In three studies, mortality was higher in hemorrhagic stroke (25%) than ischemic stroke (14%). Risk factors associated with higher mortality were admission Glasgow Coma Scale, stroke severity, age, sex, presence of hypertension, and declined renal function. Conclusion: The in-patient mortality of stroke in sub-Saharan Africa was high. Therefore, there is an urgent need for further stroke epidemiology studies in stroke subtypes and the performance of patient-level meta-analysis to understand the risk factors associated with mortality and herald appropriate intervention to curb the high mortality rate in the region.

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“…Though hypertension is the main reported risk factor of stroke among the included studies, the proportion of hypertension among stroke patients found in the current study is lower than previous studies conducted in India, Bosnia-Herzegovina, Zambia, Nigeria, Malawi, and Bangladesh [ 33 – 38 ]. The possible explanation for this variation might be due to the lack of diagnostic modalities and proficiency [ 39 ]. Additionally, this could be due to the included studies measured hypertension in the medical record prior to the occurrence of stroke [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Magnitude of risk factors and in-hospital mortality of stroke in Ethiopia: a systematic review and meta-analysis

et al. 2020

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Background The morbidity and mortality of stroke is disproportionately high in developing countries owing to the poor health care system and poor neurologic interventions. Though a number of studies were conducted to estimate the in-hospital mortality rate of stroke in Ethiopia, the lack of a nationwide study that determines the overall magnitude of risk factors and in-hospital mortality rate of stroke is an important research gap. Meta-analysis is key to improve the accuracy of estimates through the use of more data sets. Thus, this study was aimed to determine the overall magnitude of risk factors and in-hospital mortality rate of stroke in Ethiopia. Methods This study was conducted following the PRISMA checklist. We searched from Google Scholar, PubMed, Science Direct, Web of Science, CINAHL, and Cochrane Library databases for studies. Each of the original studies was assessed using a tool for the risk of bias adapted for cross-sectional studies. Data were pooled and a random effect meta-analysis model was fitted to provide the overall magnitude of risk factors and in-hospital mortality rate of stroke. Also, the subgroup analyses were performed to examine how the in-hospital mortality rate varies across different groups of studies. Results In this study, the overall magnitude of hypertension, diabetes mellitus, and atrial fibrillation among stroke patients were 47% (95%CI: 40–54), 8% (95CI%:6–12), and 10% (95%CI: 5–19), respectively. The overall in-hospital mortality of stroke in Ethiopia was 18% (95%:14–22). The highest magnitude of in-hospital mortality of stroke was observed in SNNPR and the lowest was noted in Tigray region. In addition, the magnitude of the in-hospital mortality rate of stroke was 15.1% (95%CI: 11.3–19.4), and 19.6%(95%CI: 14.1–25.7), among studies published before and after 2016, respectively. Conclusions Our pooled result showed that nearly one-fifth of stroke patients have died during hospitalization. The most common risk factor of stroke among the included studies was hypertension followed by atrial fibrillation and diabetes mellitus. There is a need for a better understanding of the factors associated with high blood pressure, especially in countries with a high risk of stroke.

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Magnitude, risk factors and outcomes of stroke at Debre Markos Referral Hospital, Northwest Ethiopia: a retrospective observational study

Cited by 29 publications

References 42 publications

Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia

Incidence and pattern of stroke among patients admitted to medical ward at Yirgalem General Hospital, Sidama Regional State, Southern-Ethiopia

In-hospital mortality and its predictors among stroke patients in sub-Saharan Africa: A systemic review and meta-analysis

Magnitude of risk factors and in-hospital mortality of stroke in Ethiopia: a systematic review and meta-analysis

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