Epidemiology and Applied Biostatistics, Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
Department of Clinical research, Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania.
BMJ Open. 2023 Jul 31;13(7):e071918. doi: 10.1136/bmjopen-2023-071918.
The burden of stroke has increased in recent years worldwide, particularly in low-income and middle-income countries. In this study we aim to determine the number of stroke admissions, and associated comorbidities, at a referral hospital in Northern Tanzania.
This was a retrospective observational study.
The study was conducted at a tertiary referral hospital, Kilimanjaro Christian Medical Centre (KCMC), in the orthern zone of Tanzania.
The study included adults aged 18 years and above, who were admitted to the medical wards from 2017 to 2019.
The primary outcome was the proportion of patients who had a stroke admitted in the medical ward at KCMC and the secondary outcome was clinical outcome such as mortality.
We conducted a retrospective audit of medical records from 2017 to 2019 for adult patients admitted to the medical ward at KCMC. Data extracted included demographic characteristics, previous history of stroke and outcome of the admission. Factors associated with stroke were investigated using logistic regression.
Among 7976 patients admitted between 2017 and 2019, 972 (12.2%) were patients who had a stroke. Trends show an increase in patients admitted with stroke over the 3 years with 222, 292 and 458 in 2017, 2018 and 2019, respectively. Of the patients who had a stroke, 568 (58.4%) had hypertension while 167 (17.2%) had diabetes mellitus. The proportion of admitted stroke patients aged 18-45 years, increased from 2017 (n=28, 3.4%) to 2019 (n=40, 4.3%). The in-hospital mortality related to stroke was 229 (23.6%) among 972 patients who had a stroke and female patients had 50% higher odds of death as compared with male patients (OR:1.5; CI 1.30 to 1.80).
The burden of stroke on individuals and health services is increasing over time, which reflects a lack of awareness on the cause of stroke and effective preventive measures. Prioritising interventions directed towards the reduction of non-communicable diseases and associated complications, such as stroke, is urgently needed.
近年来，全球范围内的卒中负担有所增加，尤其是在低收入和中等收入国家。本研究旨在确定坦桑尼亚北部一家转诊医院的卒中住院人数及其相关合并症。
这是一项回顾性观察性研究。
该研究在坦桑尼亚北部的基利马尼基督教医学中心（KCMC）进行。
该研究纳入了 2017 年至 2019 年期间入住医学病房的 18 岁及以上成年人。
KCMC 医学病房收治的卒中患者比例，次要结局为临床结局，如死亡率。
我们对 2017 年至 2019 年期间入住 KCMC 医学病房的成年患者的病历进行了回顾性审核。提取的数据包括人口统计学特征、既往卒中史和入院结局。使用逻辑回归分析卒中相关因素。
在 2017 年至 2019 年期间收治的 7976 名患者中，972 名（12.2%）为卒中患者。趋势显示，3 年来，卒中患者入院人数呈上升趋势，分别为 2017 年 222 例、2018 年 292 例和 2019 年 458 例。在卒中患者中，568 例（58.4%）患有高血压，167 例（17.2%）患有糖尿病。18-45 岁的卒中患者比例从 2017 年（n=28，3.4%）增加到 2019 年（n=40，4.3%）。972 名卒中患者中，住院期间与卒中相关的死亡率为 229 例（23.6%），女性患者的死亡风险比男性患者高 50%（OR：1.5；95%CI 1.30 至 1.80）。
随着时间的推移，卒中给个人和卫生服务带来的负担不断增加，这反映出人们对卒中病因和有效预防措施的认识不足。迫切需要优先采取干预措施，减少非传染性疾病和相关并发症（如卒中）。
