Femi Owolabi Lukman, Mansur Nagoda
Department of Medicine, Neurology Unit, Aminu Kano Teaching Hospital, Bayero University Kano, Nigeria.
J Neurosci Rural Pract. 2013 Aug;4(Suppl 1):S56-61. doi: 10.4103/0976-3147.116460.
In resource-poor setting, identification of predictors of death is of paramount importance for clinicians, so that specific therapies and management strategies can be applied to patients at high risk of dying. This study aims to determine the factors associated with death and predictors of in-patient mortality for stroke among a cohort of stroke patients in two tertiary centers in Northwestern Nigeria.
This was a prospective study of consecutive patients with acute stroke who were admitted to tertiary hospitals in northwestern Nigeria. A single observer, using pre-defined diagnostic criteria, recorded the information of interest including length of stay, outcome (dead or alive all through 30 days), time of death.
A total of 273 patients comprising 179 male and 94 female stroke patients were recruited. One hundred and seventy-four (63.7%) had infarctive stroke while 99 (36.3%) had hemorrhagic stroke (91 intracerebral and 8 sub-arachnoid hemorrhage). One-month mortality was 37%, and the majority was patients with hemorrhagic stroke (69.6%). About two-third (74.5%) of the mortalities occurred during the first week of the event. Logistic regression showed that severe systolic blood pressure, severe diastolic pressure, second or more episode of stroke, severe GCS, seizures, abnormal pupillary size, hemorrhagic stroke type, presence of aspiration pneumonitis, RBS > 200 mg/dl were independent predictors of mortality in stroke.
The present study provides information on factors associated with death in stroke. GCS < 8, seizures, abnormal pupillary size, hemorrhagic stroke, aspiration pneumonitis were independent predictors of mortality.
在资源匮乏地区，确定死亡预测因素对临床医生至关重要，这样特定的治疗方法和管理策略就能应用于有高死亡风险的患者。本研究旨在确定尼日利亚西北部两个三级医疗中心的一组中风患者中与死亡相关的因素以及住院死亡率的预测因素。
这是一项对尼日利亚西北部三级医院收治的急性中风连续患者的前瞻性研究。一名观察者使用预先定义的诊断标准，记录了包括住院时间、结局（30天内死亡或存活）、死亡时间等相关信息。
共招募了273例患者，其中包括179例男性和94例女性中风患者。174例（63.7%）为梗死性中风，99例（36.3%）为出血性中风（91例为脑出血，8例为蛛网膜下腔出血）。1个月死亡率为37%，大多数是出血性中风患者（69.6%）。约三分之二（74.5%）的死亡发生在事件的第一周。逻辑回归显示，严重收缩压、严重舒张压、第二次或更多次中风发作、严重格拉斯哥昏迷评分、癫痫发作、瞳孔大小异常、出血性中风类型、存在吸入性肺炎、随机血糖>200mg/dl是中风死亡率的独立预测因素。
本研究提供了与中风死亡相关因素的信息。格拉斯哥昏迷评分<8、癫痫发作、瞳孔大小异常、出血性中风、吸入性肺炎是死亡率的独立预测因素。
