Stroke care and outcomes in the Department of Neurology in Parakou, Benin: Retrospective cohort study

Autor: Thierry Adoukonou, Corine Houéhanou, Pervenche Fotso, Jean-Michel Vallat, Arlos Sowanou, Mendinatou Agbétou, Oyéné Kossi, Dismand Houinato, Philippe Lacroix, Pierre-Marie Preux
Přispěvatelé: Neuroépidémiologie Tropicale (NET), CHU Limoges-Institut d'Epidémiologie Neurologique et de Neurologie Tropicale-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST), Université de Limoges (UNILIM)-Université de Limoges (UNILIM), Service de Neurologie [CHU Limoges], CHU Limoges, Centre de référence national neuropathies périphériques rares [CHU Limoges], Service de l'Information Médicale et de l'Évaluation [CHU Limoges] (SIME), Laboratoire de Biostatistique et d'Informatique Médicale, Université de Limoges (UNILIM), Service de Chirurgie Thoracique et Vasculaire - Médecine vasculaire [CHU Limoges]
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Annals of Medicine and Surgery
Annals of Medicine and Surgery, Elsevier, 2020, 57, pp.148-152. ⟨10.1016/j.amsu.2020.07.041⟩
ISSN: 2049-0801
Popis: Introduction Stroke is one of the most common causes of high mortality rates in Africa with many unknown aspects around its prognosis. In this study we aim to describe stroke characteristics and in-hospital mortality of stroke in Parakou. Methods This is a retrospective cohort study including all stroke patients admitted to the Department of Neurology at Parakou Teaching Hospital from January 1, 2013 through to December 31, 2019. Clinical data, vascular risk factors, stroke subtype and outcome data were recorded. The in-hospital case-fatality and its associated factors were determined. The study was approved by the Local Ethics Committee of Biomedical research and has been registered under the unique indentifying number researchregistry5687 and is available at https://www.researchregistry.com/browse-the-registry#home/ Results Stroke cases represented 51.5% of all patients. There were 372 patients included in the study with a mean age of 58.2 ± 14.2 years. The sex ratio was 1:3. Ischemic stroke accounted for 40.3%, intracerebral hemorrhage 30.4%, and unknown 29.3%. The main vascular risk factors were hypertension (69.1%), alcoholism (23.9%) and diabetes mellitus (16.9%). The mean NIHSS at admission was 9.4 ± 5.7 and the length of hospital stay was 9.0 ± 7.3. The most common complications recorded during the acute phase were swallowing disorders (10.2%), pneumonia (9.1%) and urinary tract infections (8.3%). The in-hospital case fatality was 6.2% and was associated with loss of consciousness (p = 0.0001), high NIHSS on admission (p = 0.001), fever (p = 0.0001), swallowing disorders (p = 0.001) and leukocytosis (p = 0.021). On discharge, 27.6% were independent and 97.8% were on antihypertensive drugs. Conclusion The in-hospital stroke mortality was close to that reported by other studies in Africa.
Highlights • Subsaharan Africa (SSA) had a high burden of stroke. • The stroke unit and stroke specialists can reduce the in-hospital mortality. • We reported the low in-hospital mortality of stroke compared to those reported in SSA. • The early detection and management of acute complications may reduce the acute complications of stroke.
Databáze: OpenAIRE
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