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埃塞俄比亚吉马医疗中心收治的成年脑卒中患者的临床特征和短期结局:一项前瞻性队列研究。

Clinical characteristics and short-term outcomes of adult stroke patients admitted to Jimma Medical Center, Ethiopia: a prospective cohort study.

机构信息

Department of Internal Medicine, College of Health Science, Wollega University, Nekemte, Oromia, Ethiopia.

Department of Clinical Pharmacy, Institute of Health, Jimma University, Jimma, Oromia, Ethiopia.

出版信息

Pan Afr Med J. 2023 Jan 25;44:49. doi: 10.11604/pamj.2023.44.49.37588. eCollection 2023.

Abstract

INTRODUCTION

sub-Saharan African countries are facing a rapid increase in stroke incidence and mortality. However, there is a paucity of clinical studies on the burden of stroke and its short-term outcomes. Hence, this study is aimed at evaluating risk factors, clinical characteristics, management, and 28-day clinical outcomes among stroke patients.

METHODS

a prospective observational study was conducted at Jimma Medical Center, Ethiopia from July 2020 to January 31, 2021. All adult patients diagnosed with stroke were enrolled consecutively and followed for 28 days starting from admission. Data were analyzed using SPSS version 23 and Multivariable cox regression was used to identify factors associated with 28-day all-cause mortality.

RESULTS

among 153 patients enrolled in this study, 127 (83%) had brain CT-scan and hemorrhagic stroke accounts for 66 (52%). About half 81 (53%) of the participants were male and the mean age was 57 years. Regarding in-hospital management, antihypertensive, statins, and aspirin was given to 80 (52%), 72 (47%), and 68 (44%) patients respectively. The overall in-hospital mortality rate was 26 (17%) and the all-cause 28-day mortality rate was 39 (25.5%). Rural residence [adjusted Hazard Ratio (aHR): 2.93, 95% Confidence Interval (CI): 1.46-5.81], aspiration pneumonia (aHR= 6.57, 95% CI=3.16-13.66) and increased intracranial pressure (aHR= 3.27, 95% CI=1.56-6.86) were associated with 28-day mortality.

CONCLUSION

the patients admitted to the hospital with stroke diagnosis had high short-term mortality. Strategies focused on increasing timely arrival and evidence-based management of stroke and its complications could improve stroke patient outcomes.

摘要

简介

撒哈拉以南非洲国家的中风发病率和死亡率正在迅速上升。然而,关于中风负担及其短期结果的临床研究却很少。因此,本研究旨在评估中风患者的风险因素、临床特征、治疗方法和 28 天临床结局。

方法

本研究为前瞻性观察性研究,于 2020 年 7 月至 2021 年 1 月 31 日在埃塞俄比亚吉马医疗中心进行。连续纳入所有被诊断为中风的成年患者,并从入院开始对其进行为期 28 天的随访。采用 SPSS 版本 23 进行数据分析,采用多变量 Cox 回归来确定与 28 天全因死亡率相关的因素。

结果

在这项研究中,共纳入了 153 名患者,其中 127 名(83%)进行了脑部 CT 扫描,出血性中风占 66 例(52%)。大约一半(53%)的参与者为男性,平均年龄为 57 岁。在住院期间的治疗方面,分别有 80 名(52%)、72 名(47%)和 68 名(44%)患者接受了降压药、他汀类药物和阿司匹林治疗。总的住院死亡率为 26%(17%),全因 28 天死亡率为 39%(25.5%)。农村居住[调整后的危险比(aHR):2.93,95%置信区间(CI):1.46-5.81]、吸入性肺炎(aHR=6.57,95%CI=3.16-13.66)和颅内压升高(aHR=3.27,95%CI=1.56-6.86)与 28 天死亡率相关。

结论

因中风诊断而住院的患者短期死亡率较高。集中精力提高中风及其并发症的及时救治和循证管理水平,可能会改善中风患者的结局。

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