Management practice, and treatment outcome and its associated factors among hospitalized stroke patient at Ambo University Referral Hospital, Ethiopia: an Institutional Based Cross Sectional Study

Abstract

Background: Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past few years in Ethiopia, there is a paucity of data regarding to stroke treatment outcomes and associated factors. Hence, this study was aimed to assess management practice, and treatment outcome and its associated factors among hospitalized stroke patients.Method an institutional based cross sectional study was conducted among 111 hospitalized stroke patients in the medical ward of Ambo University Referral Hospital(AURH), who had been hospitalized for the last three years (March 30/2016- May30/2019). All patients diagnosed with stroke and hospitalized in the medical ward of AURH were included in the study. Data were analyzed with SPSS version 25.0 statistical software. Bivariate and multivariate binary logistic regression analysis was conducted to identify the predictors of poor treatment outcome.Result The present study showed that ischemic stroke was the most prevalent (80.1%) form of stroke diagnosed in the study setting. Nonetheless, 18.2% of patients were diagnosed with hemorrhagic stroke. Among 111 study participants, 69 (62.2%) patients had good treatment outcome. From 42(37.8%) study participants with poor treatment outcome, 18(42.8%) were dead and 12 (28.6%) were with disability and left against medical advice on self and family request while the remaining 12 (28.6%) were referred to other higher health facility. Social history (substance abuse P=00.046, AOR=2.684, 95%CI 1.091-6.604), age (P=0.026, AOR= 3.256, 95%CI = 1.145-9.260) and chief compliant (P=0.009, AOR=0.254, 95%CI=0.091-0.708) were the predictors of treatment outcome among hospitalized stroke patients. Other variables like types of stroke, co-morbidity, and others did not show significant association with treatment outcome.Conclusion The present study showed that ischemic stroke was the most predominantly diagnosed type of stroke in our setting. Acetyl salicylic acid and ACE inhibitor based regimens were frequently used in the management of stroke and hypertension, respectively. Nearly one third of the study participants had good treatment outcome. Nonetheless, death was reported in 16.2% of hospitalized stroke patients in the study setting. Being older and substance abusers, and the presence of hemiparesis during the initial hospital admission were significant predictors of poor treatment outcome.

In-hospital treatment outcomes of acute stroke and determinant factors in a teaching hospital in eastern Ethiopia

“…This study showed that the in-hospital mortality was 31.2% and 51.4% of the patients who died in the hospital were patients with ischemic stroke. It was also found that the proportion of patients who had an acute hemorrhagic stroke was higher when compared with previous studies conducted in other regions in Ethiopia 17 and some African countries. 22 , 23 This difference could be due to the variations in the risk factors for stroke.…”

“…In Ethiopia, a few studies have been conducted on stroke. [15][16][17][18][19] However, no study has been conducted in the eastern region where the burden of stroke and cardiovascular disease risk factors could be different from other regions. Hence, this study aimed to assess in-hospital outcomes and associated factors in stroke patients admitted to Hiwot Fana Specialized University Hospital (HFSUH) in eastern Ethiopia…”

Magnitude of in-hospital mortality and its associated factors among patients undergone laparotomy at tertiary public hospitals, West Oromia, Ethiopia, 2022

“…The study was conducted among the following three randomly selected hospitals. Ambo University Referral Hospital is teaching hospital located at in the city of Ambo, the capital of East Showa, and 114 km from the Ethiopian capital Addis Ababa and serves more than 2 catchment areas.5 million peoples (22). Nekemte Comprehensive Specialty Hospital is located in the town of Nekemte, East Wollega, Ethiopia and provide services to approximately 5 million peoples (23,24).…”

“…A conceptual framework on factors associated with in-hospital mortality among patient undergone laparotomy adapted and developed from (7,14,15,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33).…”

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“…The number of participants in each study ranged from 73 to 503. The most retrieved studies (n = 8) were from Oromia [29][30][31][32][33][34][35][36] followed by Addis Ababa (n = 7) [37][38][39][40][41][42][43], Amhara (n = 7) [44][45][46][47][48][49][50], Tigray region (n = 4) [51][52][53][54], and Southern Nations Nationalities and People's (SNNP) (n = 1) [55].…”