Stroke Burden in Rwanda: A Multicenter Study of Stroke Management and Outcome
| Autor: | Etienne Amendezo, Steven Nshuti, Severien Muneza, David Hakizimana, Emmanuel Rudakemwa, Paulin Munyemana, Agabe Emmy Nkusi, Menelas Nkeshimana |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Emergency Medical Services medicine.medical_specialty Pediatrics Population Unconsciousness 030204 cardiovascular system & hematology Risk Assessment Brain Ischemia Brain ischemia Young Adult 03 medical and health sciences 0302 clinical medicine Cost of Illness Seizures Modified Rankin Scale Case fatality rate Humans Medicine Hospital Mortality Prospective Studies cardiovascular diseases Risk factor Young adult education Prospective cohort study Stroke Aged Cerebral Hemorrhage Aged 80 and over education.field_of_study business.industry Rwanda Length of Stay Middle Aged Prognosis medicine.disease Paresis Hypertension Physical therapy Female Surgery Neurology (clinical) business 030217 neurology & neurosurgery |
| Zdroj: | World Neurosurgery. 106:462-469 |
| ISSN: | 1878-8750 |
| DOI: | 10.1016/j.wneu.2017.06.163 |
| Popis: | Background Cerebrovascular accidents or stroke constitute the second leading cause of mortality worldwide. Low- and middle-income countries bear most of the stroke burden worldwide. The main objective of this study is to determine the burden of stroke in Rwanda. Methods This was a prospective observational study in 2 parts: 6 months baseline data collection and outcome assessment sessions at 1 year. Results A total of 96 patients were enrolled in our series. Stroke constituted 2100 per 100,000 population. Of all patients, 55.2% were male and most (60%) were 55 years and older. Of all patients and/or caretakers, 22% were not aware of their previous health status and 53.5% of hypertensive patients were not on treatment by the time of the event. Median presentation delay was 72 hours for patients with ischemic stroke and 24 hours for patients with hemorrhagic stroke. Most patients had hemorrhagic stroke (65% vs. 35%), and more patients with hemorrhagic stroke presented with loss of consciousness (80% vs. 51%). Many patients (62% ischemic group and 44% hemorrhagic group) presented with severe stroke scores, and this was associated with worst outcome (P = 0.004). At 1 year follow-up, 24.7% had no or mild disability, 14.3% were significantly disabled, and 61% had died. Conclusions Our results show that stroke is a significant public health concern in Rwanda. Risk factor awareness and control are still low and case fatality of stroke is significantly high. The significant delay in presentation to care and presentation with severe stroke are major contributors for the high mortality and severe disability rates. |
| Databáze: | OpenAIRE |
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