Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda; Department of Medicine, Gulu University, Lacor, Uganda.
Department of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
J Stroke Cerebrovasc Dis. 2021 May;30(5):105661. doi: 10.1016/j.jstrokecerebrovasdis.2021.105661. Epub 2021 Mar 6.
Stroke outcome data in Uganda is lacking. The objective of this study was to capture 30-day mortality outcomes in patients presenting with acute and subacute stroke to Mbarara Regional Referral Hospital (MRRH) in Uganda.
A prospective study enrolling consecutive adults presenting to MRRH with abrupt onset of focal neurologic deficits suspicious for stroke, from August 2014 to March 2015. All patients had head computed tomography (CT) confirmation of ischemic or hemorrhagic stroke. Data was collected on mortality, morbidity, risk factors, and imaging characteristics.
Investigators screened 134 potential subjects and enrolled 108 patients. Sixty-two percent had ischemic and 38% hemorrhagic stroke. The mean age of all patients was 62.5 (SD 17.4), and 52% were female. More patients had hypertension in the hemorrhagic stroke group than in the ischemic stroke group (53% vs. 32%, p = 0.0376). Thirty-day mortality was 38.1% (p = 0.0472), and significant risk factors were National Institutes of Health Stroke Scale (NIHSS) score, female sex, anemia, and HIV infection. A one unit increase of the NIHSS on admission increased the risk of death at 30 days by 6%. Patients with hemorrhagic stroke had statistically higher NIHSS scores (p = 0.0408) on admission compared to patients with ischemic stroke, and also had statistically higher Modified Rankin Scale (mRS) scores at discharge (p = 0.0063), and mRS score change from baseline (p = 0.04).
Our study highlights an overall 30-day stroke mortality of 38.1% in southwestern Uganda, and identifies NIHSS at admission, female sex, anemia, and HIV infection as predictors of mortality.
乌干达缺乏卒中结局数据。本研究旨在捕捉在乌干达姆巴拉拉地区转诊医院（MRRH）就诊的急性和亚急性卒中患者的 30 天死亡率。
一项前瞻性研究纳入了 2014 年 8 月至 2015 年 3 月期间因突发局灶性神经功能缺损疑为卒中而就诊于 MRRH 的连续成年患者。所有患者均经头部计算机断层扫描（CT）证实为缺血性或出血性卒中。收集死亡率、发病率、危险因素和影像学特征的数据。
研究者共筛查了 134 名潜在受试者，纳入了 108 名患者。62%为缺血性卒中，38%为出血性卒中。所有患者的平均年龄为 62.5（17.4）岁，52%为女性。出血性卒中组的高血压患者多于缺血性卒中组（53%比 32%，p=0.0376）。30 天死亡率为 38.1%（p=0.0472），有显著意义的危险因素是国立卫生研究院卒中量表（NIHSS）评分、女性、贫血和 HIV 感染。入院时 NIHSS 评分增加一个单位，30 天死亡风险增加 6%。与缺血性卒中患者相比，出血性卒中患者入院时 NIHSS 评分更高（p=0.0408），出院时改良 Rankin 量表（mRS）评分更高（p=0.0063），且基线 mRS 评分变化更大（p=0.04）。
本研究在乌干达西南部发现，30 天卒中总体死亡率为 38.1%，并确定入院时 NIHSS、女性、贫血和 HIV 感染是死亡的预测因素。
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