Gebreyohannes Eyob Alemayehu, Bhagavathula Akshaya Srikanth, Abebe Tamrat Befekadu, Seid Mohammed Assen, Haile Kaleab Taye
Department of Clinical Pharmacy, University of Gondar, Gondar, Ethiopia.
Department of Internal Medicine, College of Medicine and Health Sciences, UAE Univerisity, Abu Dhabi, UAE.
Stroke Res Treat. 2019 Jan 1;2019:7275063. doi: 10.1155/2019/7275063. eCollection 2019.
Ischemic stroke is the third leading cause of mortality in low-income countries and the sixth in Ethiopia. The aim of this study was to determine the rate and predictors of in-hospital mortality due to ischemic stroke in Gondar University Hospital.
The study was conducted from April 1, 2017, to May 15, 2017, at Gondar University Hospital. A census using retrospective cohort study design was conducted on medical records of adult patients with the diagnosis of ischemic stroke attending the medical inpatient ward of Gondar University Hospital between November 2012 and September 2016. Cox hazard regression was used to determine the predictors of in-hospital mortality. A two-sided statistical test at 5% level of significance was used.
The mean (±SD) duration of hospital stay was 11.55 (10.040) days. Of the total 208 patients, 26 (12.5%) patients died in the hospital. Cox regression revealed that only a decrease in renal function, particularly elevated serum creatinine (AHR=8.848, 95% CI: 1.616-67.437), was associated with a statistically significant increase of in-hospital mortality. The symptom onset-to-admission time varied greatly among patients and ranged from 1 hour to 168 hours.
The in-hospital mortality associated with ischemic stroke was found to be high. Mainly, elevation in serum creatinine was highly associated with poorer outcomes in terms of in-hospital mortality. Much work should be done on improving the knowledge and awareness of the community regarding ischemic stroke and stroke in general to encourage early medical seeking behavior and reduce mortality and long-term disability.
缺血性中风是低收入国家的第三大死因，在埃塞俄比亚则是第六大死因。本研究的目的是确定贡德尔大学医院因缺血性中风导致的院内死亡率及其预测因素。
本研究于2017年4月1日至2017年5月15日在贡德尔大学医院开展。采用回顾性队列研究设计，对2012年11月至2016年9月期间在贡德尔大学医院内科住院病房就诊的成年缺血性中风诊断患者的病历进行普查。采用Cox风险回归分析来确定院内死亡的预测因素。使用双侧统计检验，显著性水平为5%。
平均住院时间（±标准差）为11.55（10.040）天。在总共208例患者中，26例（12.5%）患者在医院死亡。Cox回归分析显示，只有肾功能下降，特别是血清肌酐升高（风险比=8.848，95%置信区间：1.616 - 67.437）与院内死亡率的显著增加相关。患者症状发作至入院的时间差异很大，从1小时到168小时不等。
发现与缺血性中风相关的院内死亡率很高。主要是血清肌酐升高与院内死亡率方面的较差结局高度相关。在提高社区对缺血性中风及一般中风的认识和了解方面，应做大量工作，以鼓励早期就医行为，降低死亡率和长期残疾率。
