Risk factors and outcomes of stroke in a tertiary hospital in Hadhramout Governorate, Yemen

Abstract

Background: Although stroke is a major problem in Hadhramout Governorate, there is a scarcity of reliable information on risk factors of stroke and in-hospital mortality. The aim of this study was to explore the risk factors and outcomes of stroke patients admitted to Ibn Sina hospital, Hadhramout, Yemen, and to identify the predictors of in-hospital mortality. Methods: This retrospective cross-sectional study was conducted in Ibn Sina hospital in al-Mukalla district, Hadhramout Governorate, over a 4-month period (1 January 2021-30 April 2021). Results: During the study period, we recruited 100 cases of stroke, of them, 77 (77%) were males and 23 (23%) females. Their mean age was 65.42±12.78 years. The most frequent risk factor was hypertension 81 (81%), and family history was positive for stroke in 31 (31%) patients and a history of a previous stroke was present in 30 (30%) patients. Risk factors were not identified (Cryptogenic) in 5 (5%) cases. Ischemic stroke was identified in 70 (70%) cases, while hemorrhagic stroke was found in 30 (30%) patients. The in-hospital mortality was 29 (29%), and the univariate analysis found male sex, hypertension, and hemorrhagic stroke as probable predictors of in-hospital mortality. Only hemorrhagic stroke (Adjusted OR= 2.053; 95% CI=0.822-1.599; P<0.001), and hypertension (Adjusted OR= 1.677; 95% CI=0.555-1.495; P=0.011), were found to be independent predictors of mortality by multivariate logistic regression analysis. Conclusion: Stroke is a major problem in Hadhramaut Governorate with ischemic stroke being more than hemorrhagic. Men were more likely to have a stroke than women and the majority of cases were elderly. Hypertension, Diabetes mellitus, smoking, and dyslipidemia were the most commonly identified risk factors that were significantly associated with stroke. Hemorrhagic stroke and the presence of hypertension were found as risk factors for in-hospital mortality, therefore, hypertension should be well-controlled to reduce in-hospital mortality.

Epidemiology of cardiovascular diseases related admissions in a tertiary hospital in Hadramout Governorate, Yemen

“…If hypertension is not considered a cause for admission in most cases, stroke would be the most common CVD requiring admission to the medical ward in our study, accounting for 52, 5% of total admissions for CVDs, consistent with some studies from Nigeria [13,19]. In previous studies in Yemen, hypertension was the most common risk factor for stroke [18,20]. Heart failure was the second most common cause of admission accounting for 37.3% of CVD admissions in medical wards, consistent with the findings from Nigeria (36.2%) [13].…”

“…As mentioned earlier, the characteristics of each country's health status and disease spectrum are linked to its socioeconomic environment. We therefore believe that the level of psychological stress caused by poverty and instability attributed to the civil war is likely closely related to the prevalence of hypertension in our study, while poor blood pressure management in our patients was most likely attributed to non-compliance with treatment due to the high cost of drugs or their unavailability [18]. Noticeably, uncontrolled hypertension was discovered incidentally in many patients who were admitted for other CVDs.…”

Outcomes Following Carotid Endarterectomy with Patch Plasty Versus Eversion Technique: A Comparative Study of 5 Years of Experience

“…Stroke, also known as cerebrovascular accident (CVA), is the leading cause of mortality and disability worldwide [1]. In lowincome countries like Yemen, stroke is a devastating problem [2]. Among all causes of death, stroke ranks third in the world, with 13,570, or 8.72%, of total deaths in Yemen [2][3][4].…”

“…In lowincome countries like Yemen, stroke is a devastating problem [2]. Among all causes of death, stroke ranks third in the world, with 13,570, or 8.72%, of total deaths in Yemen [2][3][4]. The internal carotid artery (ICA) is confirmed to be the origin of 8% of strokes, or 13.4 strokes per 100,000 people annually [5].…”