Okeng'o Kigocha, Chillo Pilly, Gray William K, Walker Richard W, Matuja William
Internal Medicine Department, Muhimbili National Hospital, Dar es Salaam, Tanzania.
Internal Medicine Department, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
J Stroke Cerebrovasc Dis. 2017 Apr;26(4):871-878. doi: 10.1016/j.jstrokecerebrovasdis.2016.10.037. Epub 2016 Nov 29.
Stroke is a major cause of death worldwide and 85.5% of stroke deaths occur in low- and middle-income countries due to stroke. The aim of this study was to investigate correlates and predictors of 30-day mortality in stroke patients in urban Tanzania.
A prospective 30-day follow-up study was conducted at the Muhimbili National Hospital, Dar es Salaam, Tanzania. We recruited all patients with stroke seen at the Emergency Medicine Department and medical wards. Patients underwent medical history and physical examination including full neurological examination. For those who met the criteria for the diagnosis of stroke according to the World Health Organization, further data were collected, including cholesterol, creatinine, fasting blood glucose, full blood picture, human immunodeficiency virus serology, and electrocardiogram. Patients were followed up at 30 days from the date of stroke onset. The date and the cause of death of those participants who died within 30 days of stroke onset were recorded.
A total of 224 patients were recruited into the study, with follow-up data available on 186 (83.0%). At 30 days post stroke, 124 patients (66.7%) were still alive. Mortality was significantly higher among stroke patients who were over 65 years of age. Of the 62 who died, 54% died of aspiration pneumonia and 21% of septicemia. Patients with infection were 4.4 times more likely to die than thosewithout (P = .001).
Poststroke mortality rates were high. Many deaths were potentially preventable.
中风是全球主要的死亡原因，85.5%的中风死亡发生在低收入和中等收入国家。本研究的目的是调查坦桑尼亚城市中风患者30天死亡率的相关因素和预测指标。
在坦桑尼亚达累斯萨拉姆的穆希姆比利国家医院进行了一项为期30天的前瞻性随访研究。我们招募了急诊科和内科病房所有中风患者。患者接受了病史和体格检查，包括全面的神经系统检查。对于那些符合世界卫生组织中风诊断标准的患者，收集了更多数据，包括胆固醇、肌酐、空腹血糖、血常规、人类免疫缺陷病毒血清学和心电图。从中风发病之日起对患者进行30天随访。记录中风发病后30天内死亡的参与者的死亡日期和死因。
共有224名患者纳入研究，186名（83.0%）有随访数据。中风后30天，124名患者（66.7%）仍存活。65岁以上的中风患者死亡率显著更高。在62名死亡患者中，54%死于吸入性肺炎，21%死于败血症。感染患者死亡的可能性是未感染患者的4.4倍（P = 0.001）。
中风后死亡率很高。许多死亡可能是可以预防的。
