Stroke Characteristics and Outcomes of Adult Patients in Northwest Ethiopia

Abstract

Stroke is becoming one of the leading causes of adult disability and death in sub-Saharan African countries. The aim of the present study is to provide an up-to-date account of the clinical and demographic characteristics of patients with stroke admitted to the

Clinical Characteristics, Treatment Outcomes, and its Predictors Among Hospitalized Stroke Patients in Ambo University Referral Hospital, West Ethiopia: A Retrospective Hospital-Based Study

“…Hemiparesis leftsided 45 (40.5%) and right-sided 40 (36%), was the common chief complaint reported by our study participants on arrival to the hospital which is higher (36-39.7% and 21.9-29.1%, respectively) than the study reported by Temesgen et al 20 and Fikadu et al 21 The other study done in North West Ethiopia reported 81.1% of patients with stroke who sought medical treatment had hemiparesis or hemiplegia. 32 The present study also showed that 94 (84.7%) of patients had at least one comorbid condition/antecedent risk factors, ischemic stroke 74 (83.1%) and hemorrhagic stroke 19 (95.0%), before admission for stroke. Hypertension was the most frequent, ischemic stroke 39 (44.1%) and hemorrhagic stroke 9 (45.0%), antecedent risk factor identified.…”

“…16,21,28 In this study, according to WHO clinical criteria, ischemic stroke was found the most common type of stroke accounting for 80.1% of the cases, which is much higher than other studies, conducted in different hospitals in Ethiopia where the proportion of Ischemic stroke ranges from 31.5% to 69.4%. 12,19,20,[29][30][31][32] However, this finding was contrary to other studies in the country where hemorrhagic stroke was the most prevalent among stroke patients. 10,28 This could be due to differences in the prevalence of cardiovascular risk, where the previous study reported high hypertension prevalence.…”

“…It is recommended that primary prevention strategies targeting the most common risk factors for stroke in this population including hypertension should be implemented to reduce the problem. 32 Hence, overall in this study, Enalapril +Metoprolol/Atenolol 21 (18.9%) and Enalapril +Hydrochlorothiazide (Hct)/Furosemide 11 (9.9%) had been frequently prescribed for pre-existed antecedent risk factors like hypertension and/or heart disease. On other hand, the study in Nekemte referral hospital, West Ethiopia, found that nifedipine alone 70 (19.2%) was the most frequent pre-stroke medication prescribed.…”

“…This finding is consistent with the findings from other institutions in Ethiopia. 12,19,32,33 A pooled results of studies published from 2015 to 2019 in Ethiopia indicated that the overall magnitude of hypertension, diabetes mellitus, and atrial fibrillation among stroke patients were 47%, 8%, and 10%, respectively. 34 Similar patterns were also observed in our study, hypertension 49 (44.1%), atrial fibrillation 22 (19.8), and diabetes mellitus 9 (8.1%).…”

“…8 However, in resource-constrained environments, where barriers to timely CT scans delay clinical decision-making, physicians may balance the risks of aspirin administration against potential complications, 27 as different findings reported that in-hospital aspirin use was associated with decreased mortality and a decrease rate of in-hospital stroke recurrence among patients with hemorrhagic stroke. 32,35 Standard care in high-income countries is that all admitted patients with suspected acute stroke should receive a brain scan (eg, CT) to make appropriate stroke management decisions, 27 and thrombolysis using intravenous t-PA should be administered to eligible patients within 4.5 hours of hospital admission. 7 Treatment for acute stroke in developing countries is generally symptomatic; thrombolytic and neuroprotective drugs are the exception rather than the rule.…”