Treatment Outcomes and Associated Factors among Hospitalized Stroke Patients at Shashemene Referral Hospital, Ethiopia

Abstract

Background The 2013 Global Burden of Disease report indicated that 80% of stroke deaths occur in low- and middle-income regions. Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past years in Ethiopia, there is a paucity of data regarding treatment outcomes of stroke if sufficient. Hence, the present study aimed to assess patterns of treatment outcomes and associated factors among hospitalized stroke patients at Shashemene Referral Hospital. Methods A retrospective cross-sectional study was conducted at the medical ward of Shashemene Referral Hospital. A total of 73 hospitalized stroke patients during the period 2012–2017 were included in the study. Demographic characteristics, risk factors, and stroke types and their hospital outcomes were reviewed from the medical records of the patients. The data were entered and analyzed using SPSS version 16.0. Descriptive statistics such as percent and frequency were used to summarize patients' characteristics. Binary logistic regression was used to investigate the potential predictors of treatment outcome. A p-value ≤0.05 was considered statistically significant. ResultIschemic stroke was the most common type of stroke (65.8%) diagnosed in our setting. Hypertension (52.05%) was the common comorbid condition. More than half (54.79%) of the stroke patients improved on treatment. Dyslipidemics were prescribed to 68.49% of patients and the most popular antiplatelet was aspirin, which was prescribed to 61.64% of the study participants. Age, sex, type of stroke, and type of comorbidity were not significant factors of stroke treatment outcome. Conclusion Ischemic stroke was the most common type of stroke diagnosed among the study participants while aspirin and statins were the most frequently used drugs in the management of stroke. Approximately 50% of hospitalized stroke patients had good treatment outcome and none of the investigated variables were significantly associated with the treatment outcomes.

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

“…Regarding outcome of stroke patients, in-hospital mortality rate and refferal to higher health facility were recorded in 16.2% and 10.8% of patients, respectively. This finding is in agreement with other studies done by Gebremariam et al (8), Kassaw (21), Greffie et al (14), Temesgen et al (10) and de Carvalho et al (34). However, it is lower as compared to studies done at St. Paul'sTeaching Hospital (30.1%) (13) and Jimma University Hospital (37.87%) (19).…”

“…In the present study, the mean age of patients was 63.2±12.6 years, which is in line with other previous studies conducted in Ethiopia (8,10). However, it is lower than (70 ± 13) Iranian study (15) and higher than other studies conducted in Ethiopia 52±1 6(16), 53.3 (17) and 44.2±16.6 (12).…”

“…In the present study, being substance abuser had three-fold higher risk of poor treatment outcome (P = 0.046, AOR = 2.684) which is similar to studies conducted in Tikur Anibessa Specialized hospital and Felege Hiwot Referral Hospital in Bahir Dar (9,21). In contrast to this finding, social history was not significantly associated with poor treatment outcome in the study conducted at Shashemene Referral Hospital, Ethiopia and Indonesia (10,37). This disparity may be attributed to the difference in socio-demographic characteristic of the study participants.…”

“…Although stroke is currently observed to be one of the commonest reasons of admission in many Ethiopian hospitals, its prevalence in the community is not known due to the paucity of studies. Nonetheless, as per the WHO stroke mortality report, stroke mortality was estimated to be 122 and 153.8 per 100,000 for males and females, respectively in Ethiopia (8)(9)(10). As patients usually present late and the standard of care is poor as compared to developed countries, the mortality rate among hospitalized stroke patients is expected to be higher.…”

A Study of Comorbidities Among Stroke Patients Admitted In A Tertiary Level Hospital

“…Hypertension was the predominant comorbid condition (74.1%) which is consistent with a previous hospital based study (52.05%cases). 12 Other comorbid conditions found in this study were as follows, coronary heart disease ((19.5%), diabetes mellitus(17.4%), obesity(6.2%) hyperlipidemia (6.2%), CKD (4.9%), COAD(3.3%), alignancy (0.8%) Hypothyroidism (0.5%), CLD (0.5%) and Parkinsonism (0.3%).These findings were closely related to recent research conducted by Paker N et al which revealed that stroke and vascular system disorder including hypertension were most frequent comorbidity (94.2%), followed by endocrine system disorders such as diabetes mellitus, obesity and osteoporosis(76.9%) and psychiatric disorders. In another study as cited by the same author, the most frequent comorbid conditions in patients with acute stroke were reported as hypertension, constipation, hyperlipidemia, diabetes mellitus and electrocardiographic abnormalities, respectively; these findings are also relevant with present study.…”