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埃塞俄比亚西南部吉姆马大学医学中心卒中单元收治的成年患者卒中的危险因素、临床表现和预测因素:前瞻性观察研究。

Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma university medical center, south west Ethiopia: prospective observational study.

机构信息

Clinical Pharmacy Unit, Department of Pharmacy, Institute of Health Sciences, Wollega University, P.O Box 395, Nekemte, Ethiopia.

School of Pharmacy, Institute of Health, Jimma University, Jimma, Ethiopia.

出版信息

BMC Neurol. 2019 Aug 5;19(1):183. doi: 10.1186/s12883-019-1412-5.

Abstract

BACKGROUND

Stroke is the second-leading global cause of death behind heart disease in 2013 and is a major cause of permanent disability. The burden of stroke in terms of mortality, morbidity and disability is increasing across the world. It is currently observed to be one of the commonest reasons of admission in many health care setups and becoming an alarming serious public health problem in our country Ethiopia. Despite the high burden of strokes globally, there is insufficient information on the current clinical profile of stroke in low and middle income countries (LMICs) including Ethiopia. So, this study was aimed to assess risk factors, clinical presentations and predictors of stroke subtypes among adult patients admitted to stroke unit of Jimma university medical center (JUMC).

METHODS

Prospective observational study design was carried out at stroke unit (SU) of JUMC for 4 consecutive months from March 10-July 10, 2017. A standardized data extraction checklist and patient interview was used to collect data. Data was entered into Epi data version 3.1 and analyzed using SPSS version 20. Multivariable logistic regression was used to identify the predictors of stroke subtypes.

RESULT

A total of 116 eligible stroke patients were recruited during the study period. The mean age of the patients was 55.1 ± 14.0 years and males comprised 62.9%. According to world health organization (WHO) criteria of stroke diagnosis, 51.7% of patients had ischemic while 48.3% had hemorrhagic stroke. The most common risk factor identified was hypertension (75.9%) followed by family history (33.6%), alcohol intake (22.4%), smoking (17.2%) and heart failure (17.2%). The most common clinical presentation was headache complained by 75.0% of the patients followed by aphasia 60.3% and hemiparesis 53.4%. Atrial fibrillation was the independent predictor of hemorrhagic stroke (AOR: 0.08, 95% CI: 0.01-0.68).

CONCLUSION

The clinical characteristics of stroke in this set up were similar to other low- and middle-resource countries. As stroke is a high priority chronic disease, large-scale public health campaign should be launched focusing on public education regarding stroke risk factors and necessary interventions.

摘要

背景

2013 年,中风是仅次于心脏病的全球第二大致死原因,也是导致永久性残疾的主要原因。全球范围内,中风的死亡、发病和残疾负担正在增加。目前,中风是许多医疗保健机构中最常见的入院原因之一,也是我国埃塞俄比亚一个令人震惊的严重公共卫生问题。尽管中风在全球范围内负担沉重,但关于包括埃塞俄比亚在内的低收入和中等收入国家(LMICs)中风的当前临床概况的信息不足。因此,本研究旨在评估成人患者入住 Jimma 大学医学中心(JUMC)中风病房的中风亚型的危险因素、临床表现和预测因素。

方法

2017 年 3 月 10 日至 7 月 10 日,在 JUMC 的中风病房进行了为期 4 个月的前瞻性观察研究设计。使用标准化数据提取检查表和患者访谈来收集数据。数据输入 EpiData 版本 3.1,并使用 SPSS 版本 20 进行分析。多变量逻辑回归用于确定中风亚型的预测因素。

结果

在研究期间共招募了 116 名符合条件的中风患者。患者的平均年龄为 55.1±14.0 岁,男性占 62.9%。根据世界卫生组织(WHO)中风诊断标准,51.7%的患者为缺血性中风,48.3%为出血性中风。确定的最常见危险因素是高血压(75.9%),其次是家族史(33.6%)、饮酒(22.4%)、吸烟(17.2%)和心力衰竭(17.2%)。最常见的临床表现是头痛,75.0%的患者抱怨头痛,其次是失语症(60.3%)和偏瘫(53.4%)。心房颤动是出血性中风的独立预测因素(AOR:0.08,95%CI:0.01-0.68)。

结论

本研究中风的临床特征与其他中低收入国家相似。由于中风是一种高优先级的慢性疾病,应开展大规模的公共卫生运动,重点开展针对中风危险因素和必要干预措施的公众教育。

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