Zewudie Ameha Zeleke, Regasa Tolcha, Hambisa Solomon, Nureye Dejen, Mamo Yitagesu, Aferu Temesgen, Feyissa Desalegn, Yosef Tewodros
Mizan-Tepi University, College of Health Science, Department of Pharmacy, Mizan-Aman, Ethiopia.
Mizan-Tepi-University, College of Medicine and Health Science, School of Public Health, Department of Epidemiology and Biostatistics, Mizan-Aman, Ethiopia.
Stroke Res Treat. 2020 Dec 30;2020:8817948. doi: 10.1155/2020/8817948. eCollection 2020.
Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC).
A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1, 2016 to March 30, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with value less than 0.05 were considered as statically significant determinants of poor treatment outcome.
Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, = 0.03) were independent predictors of poor treatment outcomes.
Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).
中风是埃塞俄比亚的一个公共卫生问题。尽管埃塞俄比亚中风的患病率很高，但关于药物治疗、治疗结果以及中风治疗效果不佳的危险因素的数据却很少。因此，本研究旨在评估吉马大学医学中心（JUMC）中风科收治患者的治疗效果及其决定因素。
采用一项为期两年的基于医院的回顾性横断面研究，分析2016年2月1日至2018年3月30日期间在吉马大学医学中心中风科收治的中风患者的病历。数据由Epidata manager 4.0.2版本录入，并通过SPSS 24版本进行分析。采用向后逐步法进行多变量逻辑回归分析，以确定中风治疗效果不佳的独立预测因素。P值小于0.05的变量被视为治疗效果不佳的统计学显著决定因素。
在吉马大学收治的220例中风患者中，67.30%为男性。其中近三分之二（63.18%）的患者治疗效果不佳。60%的患者接受了调脂药物治疗，最常用的抗血小板药物是阿司匹林，67.3%的患者使用了该药物。年龄≥65岁调整后的优势比（AOR）：2.56；95%置信区间：1.95 - 9.86，P = 0.001）、合并症的存在（AOR：5.25；95%置信区间：1.08 - 17.69，P < 0.001）、出血性中风入院（AOR：18.99；95%置信区间：7.05 - 42.07，P < 0.001）以及中风发作24小时后入院（AOR：4.98；95%置信区间：1.09 - 21.91，P = 0.03）是治疗效果不佳的独立预测因素。
大量中风患者治疗效果不佳。老年患者、诊断为出血性中风的患者、合并症患者以及入院延迟的患者更有可能治疗效果不佳。因此，应特别关注上述患者，进行频繁监测和护理。尤其对于有中风危险因素（心血管疾病）的患者，应提高对早期入院重要性的认识。
