津巴布韦三家三级医院收治的中风患者的临床特征与结局：一项为期一年的回顾性研究。
Clinical characteristics and outcomes of patients with stroke admitted to three tertiary hospitals in Zimbabwe: A retrospective one-year study.
作者信息
Kaseke Farayi, Stewart Aimee, Gwanzura Lovemore, Hakim James, Chikwasha Vasco
机构信息
Department of Rehabilitation, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe.
Department of Physiotherapy, School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa.
出版信息
Malawi Med J. 2017 Jun;29(2):177-182. doi: 10.4314/mmj.v29i2.19.
BACKGROUND
Epidemiological data on stroke in Zimbabwe are scarce and few clinical studies have been performed to date.
METHODS
A retrospective review of the medical records of patients admitted for stroke during the year 2012 was performed at three tertiary hospitals. Sociodemographic data were recorded alongside with comorbidities and outcomes. Scoping over a period of one year using records of patients admitted for stroke helped to quantify and qualify the stroke problem. Descriptive analysis was done using STATA version 13.0.
RESULTS
A total of 450 stroke cases, (63% women) were included in the final analysis. The proportion of stroke cases among the admissions was 0.61%. Mean age of the stroke patients was 61.6±16.8 years (95% CI=60.1; 63.2). Risk factors were hypertension (58.5%), diabetes (18%) and HIV, (14%)). Diagnosis was clinical and 39.4% had a CT scan. Mean length of hospital stay was 8.1±5.6 days with a significance difference noted among hospitals (p<0.001). In-hospital mortality was 24.9%, 95% CI (20.9; 29.0%). Mortality was associated with place of admission (p<0.001). Gender and side of stroke were significantly associated (p<0.001).
CONCLUSIONS
The sociodemographic characteristics mirrored findings from elsewhere. Mean age was higher than reported for Zimbabwe in the nineties and lately for Malawi. Majority of patients were female, elderly and hypertensive in line with findings from other countries. Presence of HIV is supported by recent studies from Malawi and South Africa. The relationship between gender and side affected needs further research. There is need to standardise acute care through proper diagnosis to reduce mortality. There is need to support caregivers post-discharge. Data-handling is poor and there is limited capacity for Sub Saharan Africa hospitals to provide optimal stroke care. This may have long term implications on the outcome of survivors and caregivers. There is need of vigilance in acute stroke care.
背景
津巴布韦关于中风的流行病学数据匮乏，迄今为止开展的临床研究很少。
方法
对2012年期间三家三级医院收治的中风患者的病历进行回顾性分析。记录社会人口统计学数据以及合并症和治疗结果。利用中风患者的入院记录进行为期一年的范围界定，有助于对中风问题进行量化和定性。使用STATA 13.0版本进行描述性分析。
结果
最终分析纳入了450例中风病例（63%为女性）。中风病例在入院患者中的比例为0.61%。中风患者的平均年龄为61.6±16.8岁（95%置信区间=60.1；63.2）。危险因素包括高血压（58.5%）、糖尿病（18%）和艾滋病毒（14%）。诊断依靠临床判断，39.4%的患者进行了CT扫描。平均住院时间为8.1±5.6天，不同医院之间存在显著差异（p<0.001）。住院死亡率为24.9%，95%置信区间（20.9；29.0%）。死亡率与入院地点相关（p<0.001）。性别与中风部位显著相关（p<0.001）。
结论
社会人口统计学特征与其他地方的研究结果相似。平均年龄高于津巴布韦九十年代以及最近马拉维报告的年龄。与其他国家的研究结果一致，大多数患者为女性、老年人且患有高血压。马拉维和南非最近的研究证实了艾滋病毒的存在。性别与受影响部位之间的关系需要进一步研究。需要通过正确诊断来规范急性护理以降低死亡率。需要在出院后为护理人员提供支持。数据处理较差，撒哈拉以南非洲医院提供最佳中风护理的能力有限。这可能对幸存者和护理人员的结局产生长期影响。急性中风护理需要保持警惕。
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