Najjuma Josephine Nambi, Kintu Timothy Mwanje, Nakibuuka Jane, Kaddumukasa Mark, Mbalinda Scovia N, Kaddumukasa Martin, Burant Christopher, Moore Shirley, Sajatovic Martha, Nuwagira Edwin
Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda.
Department of Internal Medicine, College of Health Sciences, Makerere University, Kampala, Uganda.
Int J Emerg Med. 2025 Apr 7;18(1):72. doi: 10.1186/s12245-025-00830-6.
Stroke, a leading cause of global morbidity and mortality, disproportionately impacts low and middle-income countries, particularly in sub-Saharan Africa (SSA) which reports the highest stroke burden. The COVID-19 pandemic further complicated this situation, emerging as a significant stroke risk factor. The pandemic also disrupted healthcare systems worldwide, affecting stroke management and care accessibility, and leading to deteriorated conditions in stroke patients upon hospital admission. In this pre/during COVID-19 pandemic analysis of acute stroke cases presenting to a Ugandan hospital, we investigated the relationship between stroke admissions, management and treatment outcomes.
This was a retrospective medical record review in which we analyzed medical charts of stroke patients admitted to Mbarara Regional Referral Hospital in 2019 (pre-COVID-19) and 2020 (during COVID-19). Socio-demographic data, stroke subtypes, medical history, and physical examination findings were extracted from the hospital records. Data analysis was performed using R-Studio, employing descriptive statistics and inferential analyses to compare stroke characteristics and outcomes across the two periods.
Data from 175 stroke patients was analyzed, with higher admission numbers in 2020 (69.7%), but a slightly higher mortality rate in 2019 as compared to 2020 (22.6% versus 18.9%, p = 0.711). A significant increase in acute ischemic stroke cases was observed in 2020, with no significant differences in stroke severity or functional ability between the two years. Clinical parameters such as admission oxygen saturation, blood sugar, temperature, and Glasgow Coma Scale (GCS) score, along with complications like aspiration pneumonia and infections, correlated with mortality. There was no significant difference in survival probability between pre- and during-pandemic periods. Admission GCS, pulse rate, and aspiration pneumonia were significant predictors of 14-day in-hospital mortality.
The surge in acute ischemic stroke cases during the pandemic highlights the need for robust stroke care systems, especially in high-burden regions like SSA. Some key predictors of mortality are potentially modifiable, suggesting that early intervention and vigilant monitoring of risk parameters could improve survival rates. Findings also highlight the need for tailored care strategies and health system improvements especially during public health emergencies to enhance patient outcomes.
Not Applicable.
中风是全球发病和死亡的主要原因，对低收入和中等收入国家的影响尤为严重，特别是在撒哈拉以南非洲地区（SSA），该地区的中风负担最为沉重。2019冠状病毒病（COVID-19）大流行使这种情况更加复杂，它已成为一个重要的中风风险因素。该大流行还扰乱了全球医疗系统，影响了中风的管理和医疗服务可及性，并导致中风患者入院时病情恶化。在本次对一家乌干达医院收治的急性中风病例进行的COVID-19大流行前/期间分析中，我们调查了中风入院情况、管理与治疗结果之间的关系。
这是一项回顾性病历审查，我们分析了2019年（COVID-19大流行前）和2020年（COVID-19大流行期间）入住姆巴拉拉地区转诊医院的中风患者的病历。从医院记录中提取社会人口统计学数据、中风亚型、病史和体格检查结果。使用R-Studio进行数据分析，采用描述性统计和推断性分析来比较两个时期的中风特征和结果。
分析了175例中风患者的数据，2020年的入院人数较多（69.7%），但2019年的死亡率略高于2020年（22.6%对18.9%，p = 0.711）。2020年急性缺血性中风病例显著增加，两年间中风严重程度或功能能力无显著差异。入院时的血氧饱和度、血糖、体温和格拉斯哥昏迷量表（GCS）评分等临床参数，以及吸入性肺炎和感染等并发症与死亡率相关。大流行前和大流行期间的生存概率无显著差异。入院时的GCS评分、脉搏率和吸入性肺炎是14天院内死亡率的重要预测因素。
大流行期间急性缺血性中风病例的激增凸显了强大的中风护理系统的必要性，特别是在撒哈拉以南非洲等中风负担高的地区。一些死亡率的关键预测因素可能是可改变的，这表明早期干预和对风险参数的密切监测可以提高生存率。研究结果还凸显了制定针对性护理策略和改善卫生系统的必要性，特别是在突发公共卫生事件期间，以改善患者预后。
不适用。
