Mortalité des patients hospitalisés pour AVC ischémique en neurologie au CHU de Fann à Dakar

Touré, Kamadore; Sawadogo, A.A.; Sow, Adjaratou Dieynabou; Basse, Anna Modji; Diagne, N.S.; Diop, Marième Soda; Gaye, Ndiaga Matar; Diop, Amadou Gallo; Cisse, O.; Seck, Lala Bouna; Coumé, M.; Ndiaye, M.

doi:10.1016/j.npg.2016.11.006

Cited by 9 publications

(6 citation statements)

References 20 publications

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“…In Dakar, stroke is the leading neurological condition requiring hospitalization. Stroke represents more than 30% of hospitalizations and is responsible for nearly two-thirds of deaths observed in the neurology department [ 5 ]. Its incidence is estimated at 1-2% in the general population in Senegal [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Pre-hospital delay in patients with ischemic stroke in the Fann Teaching Hospital, Dakar, Senegal in 2020

Damon¹,

Basse²,

Sow³

et al. 2022

Pan Afr Med J

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Introduction stroke is a cerebrovascular disease. Early reperfusion in neurovascular units can reduce its morbidity and mortality. Even when neurovascular units exist, patients usually arrive late in the emergency department. to the purpose of this study was to determine prehospital delay in patients with acute ischemic stroke and associated factors. Methods we conducted a retrospective cross-sectional study in the neurology department of the Fann University Hospital in Dakar from January 1 s t to June 30 th , 2020. We included patients younger than 80 years seen in the emergency unit for ischemic stroke. The median time to presentation was calculated based on the time of stroke onset and that of arrival at the hospital. Multivariate analysis was used to determine factors associated with prehospital delay. Results a total of 56 patients were enrolled, among whom 58.6% arrived at the hospital in less than 3 hours. Of them, 37.5% presented to a level 3 or 4 hospital first. Less than 34% of our patient presented to a level 2-3 hospital in less than 3 hours. Based on bi- and multivariate analysis, being married (OR = 7.2 [CI à 95%: 1.5 - 35.8]), being a female (OR = 5.5 [CI à 95%: 1.5 - 19.8]) and having stroke during week days (OR = 4.3 [CI à 95%: 1.3-13.9]) were associated with prehospital delay. Conclusion most of our patients arrived late at a level 2 or 3 hospital. Being a married woman increased the risk of late arrival. This study highlights the importance of improving awareness in order to increase the proportion of patients potentially eligible for revascularization.

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Section: Introductionmentioning

confidence: 99%

Pre-hospital delay in patients with ischemic stroke in the Fann Teaching Hospital, Dakar, Senegal in 2020

Damon¹,

Basse²,

Sow³

et al. 2022

Pan Afr Med J

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“…In addition, the present review revealed that acute mortality ranged from 3% to 13%. These results are lower than the rates reported in other Arab and African countries [72, 73]. These rates are below the estimated mortality rate described (18%) in sub-Saharan Africa during the first week of 2013 [74].…”

Section: Discussionmentioning

confidence: 54%

“…Despite the importance of atherosclerotic ischemic and embolic origins in the context of studies of populations, the present critical review demonstrated low rates of lethality and minor rates of occlusion of small arteries [73]. These findings could be due to the implementation of a strategy of diagnosis and effective etiological treatment of cerebral ischemia in the studies we included in our review.…”

Section: Discussionmentioning

confidence: 79%

Ischemic stroke in Morocco: a systematic review

et al. 2019

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BackgroundThe aim of this systematic review is to determine the epidemiological and etiological profiles, the influential factors of the prehospital delay, thrombolysis management, the acute and 3-month mortality rate and the genetic aspect of ischemic stroke in Morocco.MethodsThe present work is a systematic review that was conducted according to the recommendations of the “Preferred reporting items for systematic reviews and meta-analysis”. We used Pubmed, Sciencedirect, Scopus, Clinicalkey, and Google scholar databases for the raking of the gray literature during the time frame 2009 and 2018. The protocol of the review was registered in the PROSPERO register (CRD42018115206).These studies were analyzed based on: Age, sex ratio, risk factors, etiological profile according to Trial of ORG classification 10,172 in Acute Stroke Treatment, prehospital delay average and its influential factors, thrombolyzed patients’ proportion, acute and 3-month mortality and the genetic factors of ischemic stroke in Morocco.ResultsTwenty-nine (n = 29) studies were selected. The average age ranged from 49 ± 15.2 to 67.3 ± 9.9 years old. Moreover, we reported male predominance within all ages in 13 studies. High blood pressure, diabetes, smoking and heart disease were the four identified main risk factors by the prementioned studies. Atherosclerosis and cardioembolic were the main described etiologies of cerebral ischemia, and the average prehospital time ranged from 26 to 61.9 h. The proportion of thrombolysed patients ranged from 1.8% to 2.9%, the mortality rate varied in the acute phase from 3 to 13%, and the 3-month mortality ranged from 4.3 to 32.5%. It is also important to highlight that most of these studies, which were conducted in hospital environment, have a reduced sample size and no confidence interval.ConclusionsIschemic stroke is affecting more likely the young population with male predominance. Moreover, the long prehospital delay and the low proportion of thrombolysed patients are alarming. This indicates the need to investigate in depth the key factors influencing the access to care for Moroccan patients in order to improve the management of this neurologic deficit in Morocco.

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“…The association between early seizures and a pejorative neurologic course has already been demonstrated [19,22,23]. Hyperglycemia is considered to be a poor prognostic factor in stroke in general, and perhaps even more so in the presence of seizures [24][25][26].…”

Section: Discussionmentioning

confidence: 99%