Walker R W, Wakefield K, Gray W K, Jusabani A, Swai M, Mugusi F
Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.
Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK.
Acta Neurol Scand. 2016 Jan;133(1):49-54. doi: 10.1111/ane.12422. Epub 2015 May 5.
The burden of stroke on healthcare services in sub-Saharan Africa (SSA) is increasing. However, long-term outcomes from stroke in SSA are not well described. We aimed to investigate case-fatality and health outcomes for stroke survivors at 7- to 10-year follow-up.
The Tanzanian Stroke Incidence Project (TSIP) recruited incidence stroke cases between 2003 and 2006. We followed up cases in 2013, recording date of death in those who had died.
Of 130 stroke cases included in this study, case-fatality and date of death data were available for 124 at 7-10 years post-stroke. Of these, 102 (82.3%) had died by 7 years post-stroke. Functional disability, as measured by the Barthel index immediately post-stroke, was a significant predictor of case-fatality at seven-year follow-up with those with severe disability having an almost four-fold increase in the odds of death compared with those with no, mild or moderate disability.
Case-fatality rates are higher than reported in high-income countries, with post-stroke disability a significant predictor of death. Sustainable interventions to reduce post-stroke disability in this setting should be investigated.
撒哈拉以南非洲地区（SSA）中风给医疗服务带来的负担正在增加。然而，SSA地区中风的长期预后情况尚无详尽描述。我们旨在调查中风幸存者在7至10年随访期的病死率及健康状况。
坦桑尼亚中风发病率项目（TSIP）在2003年至2006年期间招募中风发病病例。我们于2013年对病例进行随访，记录已死亡者的死亡日期。
本研究纳入的130例中风病例中，有124例在中风后7至10年的病死率及死亡日期数据可用。其中，102例（82.3%）在中风后7年内死亡。中风后即刻用巴氏指数衡量的功能残疾是7年随访期病死率的显著预测因素，与无残疾、轻度或中度残疾者相比，重度残疾者死亡几率几乎增加了四倍。
病死率高于高收入国家报告的水平，中风后残疾是死亡的重要预测因素。应研究在这种情况下减少中风后残疾的可持续干预措施。
