Stroke Event Factors among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Observational Study

Abstract

Background. The fact that the majority of patients come late creates management difficulties as these first hours are important to avoid secondary insults to the brain and preserve the ischemic penumbra. Although thrombolytic treatments are currently not available in our hospital, significant delays during the prehospital or in-hospital phases of care create management difficulties and would make such advanced treatments impossible in the future in Ethiopia. Methods. Prospective observational study was carried at stroke unit of Jimma University Medical Center for 4 consecutive months from March 10 to July 10, 2017. Data was cleaned and entered to Epidata version 3.1 and then exported and analyzed using SPSS version 20.0. Results. A total of 116 eligible stroke patients were recruited during the study period with mean age of 55.1±14.0 years, ranging from 23 to 96 years. The majority of stroke patients were males (62.9%) and from rural areas (72.4%). The median time elapsed between the onset of stroke symptoms and arrival to the hospital was 27 hours. Almost half (47.4%) of the patients presented within 24 hours and 26 (22.4%) patients presented to hospital beyond 72 hours. Majority of patients (40.5%) showed severe neurological deficit on admission and the mean National Institute of health stroke scale (NIHSS) was 15.71 ± 7.52. The mean Glasgow coma scale (GCS) was moderate (12.12±3.35). On hospital arrival systolic blood pressure (SBP) was highly elevated (≥140 mm Hg) in 65.5% of the patients. The circadian pattern showed a significant peak in morning for hemorrhagic stroke (35.7%) and afternoon for ischemic stroke (38.3%). Conclusions. The delay of hospital arrival was a challenge similar to other high income countries for early management of the patients. Studies that attempt to determine some of the factors that impede timely presentation in patients with strokes are advisable to address those issues further.

Burden, clinical outcomes and predictors of time to in hospital mortality among adult patients admitted to stroke unit of Jimma university medical center: a prospective cohort study

“…According to the CT scan findings, 30 (49.2 %) patients were found to have infarction while 31 (50.8%) had hemorrhagic stroke [31]. Overall using WHO criteria, 60 (51.7%) of the patients had ischemic stroke (IS) while 56 (48.3%) had hemorrhagic stroke (HS) [25,27]. History was obtained solely from 11 (9.5%) patients themselves, 50 (43.1%) from the patients and caregivers as well as in 55(47.4%) solely from relatives and/or caregivers.…”

“…• mRS: 6 (death) NIHSS: helps to assess the severity of stroke and the intervals were defined as [19,27]…”

Burden, Clinical Outcomes and Predictors of Stroke in Hospital Mortality among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Cohort Study

“…According to the CT scan findings, 30 (49.2 %) patients were found to have infarction while 31 (50.8%) had hemorrhagic stroke [ 21 ]. Over all using WHO criteria, 60 (51.7%) of the patients had ischemic stroke while 56 (48.3%) had hemorrhagic stroke [ 20,22]. History was obtained solely from 11 patients (9.5%), from the patient and caregiver or other informant in 50 cases (43.1%), and solely from relatives and/or friends in 55 cases (47.4%).…”

“…Permission was obtained from all authors for using previously published (table 1). Thus we acknowledge the authors of the article [ 20,22].…”

Burden, Clinical Outcomes and Predictors of time to in Hospital Mortality among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Cohort Study

“…Young stroke (age < 45 years) comprised of 22.4% of all patients. Males comprised of 73 (62.9%) with male: female ratio of 1.70:1 [25,27] (Table 1). Seventeen patients (14.7%) discharged within 3 days and 22 patients (19.0%) stayed for greater than 2 weeks after hospital admission ( Table 2).…”