埃塞俄比亚西北部中风患者的生存状况及死亡预测因素

The Survival Status and Predictors of Mortality Among Stroke Patients at North West Ethiopia.

作者信息

Walelgn Nigusie, Abyu Gebre Yitayih, Seyoum Yeshaneh, Habtegiorgis Samuel Derbie, Birhanu Molla Yigzaw

机构信息

Department of Adult Health Nursing, College of Medicine and Health Sciences, Bahirdar University, Bahirdar, Ethiopia.

Department of Public Health, College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

Risk Manag Healthc Policy. 2021 Jul 14;14:2983-2994. doi: 10.2147/RMHP.S322001. eCollection 2021.

Abstract

INTRODUCTION

Stroke is one of the commonest non-communicable disease types that has a great public health impact both in developed and developing countries. However, in Ethiopia, the long-term survival status of stroke patients is not very understood. This study aimed at assessing survival status and predictors of mortality among stroke patients at Felege Hiwot comprehensive specialized hospital from September 1, 2014, to August 31, 2019, Bahirdar, North West Ethiopia.

METHODS

An institutional-based retrospective cohort study was conducted using 368 registered stroke patients between September 1, 2014, and August 31, 2019. We used Kaplan-Meier together with a Log-rank test to compare the survival rate of the study participants using categorical variables and to compare covariate and both bi-variable and multivariable Cox proportional hazards regression analysis model was conducted to identify predictors of mortality among stroke patients. The association between outcome and independent variables was expressed using an adjusted hazard ratio (AHR) with a 95% confidence interval and statistical significances were declared at P-value of <0.05.

RESULTS

Fifty-six (15.2%) of the 368 stroke patients included in the study died, and 312 (84.8%) were correctly censored. The overall survival rate was 72.2% at 51 months of follow-up with a median survival time of 0.26 months. Age greater than 65 (AHR 6.31, 95% CI 1.75-22.74), body temperature >7.1 degree centigrade (AHR = 7.14, 95% CI: 2.76-18.5), potassium level below <2 mmol/l (AHR = 2, 95% CI: 1.9-23.53) and creatinine level >1.2 mg/dl (AHR = 7.85, 95% CI: 2.7-22.6) were predictive predictors of mortality.

CONCLUSIONS

In the follow-up of 51 months, significant mortality occurred. Important predictive predictors of survival status were identified. Interventions should be focused on health education and awareness creation of the community for the early management of stroke.

摘要

引言

中风是最常见的非传染性疾病类型之一,在发达国家和发展中国家都对公众健康产生重大影响。然而,在埃塞俄比亚,中风患者的长期生存状况尚不太清楚。本研究旨在评估2014年9月1日至2019年8月31日期间,位于埃塞俄比亚西北部巴赫达尔的费莱格·希沃特综合专科医院中风患者的生存状况及死亡预测因素。

方法

采用基于机构的回顾性队列研究,研究对象为2014年9月1日至2019年8月31日期间登记的368例中风患者。我们使用Kaplan-Meier法和对数秩检验,通过分类变量比较研究参与者的生存率,并采用协变量以及双变量和多变量Cox比例风险回归分析模型来确定中风患者死亡的预测因素。结果与自变量之间的关联用调整风险比(AHR)及95%置信区间表示,P值<0.05时具有统计学意义。

结果

纳入研究的368例中风患者中有56例(15.2%)死亡,312例(84.8%)被正确截尾。随访51个月时的总生存率为72.2%,中位生存时间为0.26个月。年龄大于65岁(AHR 6.31,95%CI 1.75 - 22.74)、体温>37.1摄氏度(AHR = 7.14,95%CI:2.76 - 18.5)、血钾水平低于<2 mmol/l(AHR = 2,95%CI:1.9 - 23.53)和肌酐水平>1.2 mg/dl(AHR = 7.85,95%CI:2.7 - 22.6)是死亡的预测因素。

结论

在51个月的随访中,出现了显著的死亡率。确定了生存状况的重要预测因素。干预措施应侧重于对社区进行健康教育和提高意识,以便对中风进行早期管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ac3/8286726/fc3de2ac980f/RMHP-14-2983-g0001.jpg

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