The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study
Background. Despite stroke being a leading cause of morbidity and mortality globally, there is a dearth of information on the burden and outcomes of stroke in sub-Saharan Africa and Namibia in particular. Methods. A hospital-based, retrospective cohort study was conducted to analyse non-electronic m...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Hindawi Limited
2023-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2023/1978536 |
| _version_ | 1826993056811843584 |
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| author | Saara Ndinelago Neshuku Jessica Kirchner-Frankle Maria Nangolo Maria Moses Chalese Olivia Einbeck Percy Kumire Vaja Zatjirua Justor Banda |
| author_facet | Saara Ndinelago Neshuku Jessica Kirchner-Frankle Maria Nangolo Maria Moses Chalese Olivia Einbeck Percy Kumire Vaja Zatjirua Justor Banda |
| author_sort | Saara Ndinelago Neshuku |
| collection | DOAJ |
| description | Background. Despite stroke being a leading cause of morbidity and mortality globally, there is a dearth of information on the burden and outcomes of stroke in sub-Saharan Africa and Namibia in particular. Methods. A hospital-based, retrospective cohort study was conducted to analyse non-electronic medical records of all consecutive stroke patients who were admitted to one of the highest tertiary-level hospitals in Namibia for 12 months (2019-2020). The primary outcome of the study was to establish the in-hospital mortality, stroke subtypes, and associated complications. Results. In total, 220 patients were included in the study, their mean age was 53 (SD13.8) years, and 55.5% were males. 61.0% had an ischaemic stroke (IS), and 39.0% had a haemorrhagic stroke (HS). The mean age was significantly lower in patients with HS vs. IS (48.2±12.2 vs. 56.1±13.3, p<0.001). Of the IS patients, the majority (29.0%) had total anterior circulation infarct (TACI), while in the HS group, 34.0% had basal ganglia haemorrhage with or without intraventricular extension. Hypertension (p=0.015), dyslipidaemia (p=0.001), alcohol consumption (p=0.022), and other cardiovascular diseases (p=0.007) were more prevalent in patients with IS compared to those with HS. The prevalence rate of intravenous thrombolysis was 2.2% in IS and use of intravenous antihypertensives in 25.9% of patients with HS than IS. The in-hospital mortality was 26.4% with complications such as raised ICP, aspiration pneumonia, hydrocephalus, and sepsis significantly high in those that died. Aspiration pneumonia (OR 2.79, 95% CI 1.63-4.76, p<0.001) and increased ICP (OR 0.30, 95% CI 0.16-057, p<0.001) were independent predictors of in-hospital mortality on the multivariate analysis. Conclusion. Our findings showed a younger mean age for stroke and mortality rate comparable to other low- to middle-income countries (LMICs). Hypertension and alcohol consumption were the main risk factors for both stroke subtypes, while aspiration pneumonia and raised intracranial pressure predicted in-hospital mortality. |
| first_indexed | 2024-04-10T15:38:02Z |
| format | Article |
| id | doaj.art-a8dd879284c641d486eee33fb15f2ea9 |
| institution | Directory Open Access Journal |
| issn | 2042-0056 |
| language | English |
| last_indexed | 2025-02-18T08:58:03Z |
| publishDate | 2023-01-01 |
| publisher | Hindawi Limited |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj.art-a8dd879284c641d486eee33fb15f2ea92024-11-02T23:54:01ZengHindawi LimitedStroke Research and Treatment2042-00562023-01-01202310.1155/2023/1978536The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort StudySaara Ndinelago Neshuku0Jessica Kirchner-Frankle1Maria Nangolo2Maria Moses3Chalese Olivia Einbeck4Percy Kumire5Vaja Zatjirua6Justor Banda7Department of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Internal MedicineDepartment of Medical SciencesDepartment of Medical SciencesDepartment of Medical SciencesDepartment of Medical SciencesBackground. Despite stroke being a leading cause of morbidity and mortality globally, there is a dearth of information on the burden and outcomes of stroke in sub-Saharan Africa and Namibia in particular. Methods. A hospital-based, retrospective cohort study was conducted to analyse non-electronic medical records of all consecutive stroke patients who were admitted to one of the highest tertiary-level hospitals in Namibia for 12 months (2019-2020). The primary outcome of the study was to establish the in-hospital mortality, stroke subtypes, and associated complications. Results. In total, 220 patients were included in the study, their mean age was 53 (SD13.8) years, and 55.5% were males. 61.0% had an ischaemic stroke (IS), and 39.0% had a haemorrhagic stroke (HS). The mean age was significantly lower in patients with HS vs. IS (48.2±12.2 vs. 56.1±13.3, p<0.001). Of the IS patients, the majority (29.0%) had total anterior circulation infarct (TACI), while in the HS group, 34.0% had basal ganglia haemorrhage with or without intraventricular extension. Hypertension (p=0.015), dyslipidaemia (p=0.001), alcohol consumption (p=0.022), and other cardiovascular diseases (p=0.007) were more prevalent in patients with IS compared to those with HS. The prevalence rate of intravenous thrombolysis was 2.2% in IS and use of intravenous antihypertensives in 25.9% of patients with HS than IS. The in-hospital mortality was 26.4% with complications such as raised ICP, aspiration pneumonia, hydrocephalus, and sepsis significantly high in those that died. Aspiration pneumonia (OR 2.79, 95% CI 1.63-4.76, p<0.001) and increased ICP (OR 0.30, 95% CI 0.16-057, p<0.001) were independent predictors of in-hospital mortality on the multivariate analysis. Conclusion. Our findings showed a younger mean age for stroke and mortality rate comparable to other low- to middle-income countries (LMICs). Hypertension and alcohol consumption were the main risk factors for both stroke subtypes, while aspiration pneumonia and raised intracranial pressure predicted in-hospital mortality.http://dx.doi.org/10.1155/2023/1978536 |
| spellingShingle | Saara Ndinelago Neshuku Jessica Kirchner-Frankle Maria Nangolo Maria Moses Chalese Olivia Einbeck Percy Kumire Vaja Zatjirua Justor Banda The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study Stroke Research and Treatment |
| title | The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study |
| title_full | The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study |
| title_fullStr | The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study |
| title_full_unstemmed | The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study |
| title_short | The Burden and In-Hospital Mortality of Stroke Admissions at a Tertiary Level Hospital in Namibia: A Retrospective Cohort Study |
| title_sort | burden and in hospital mortality of stroke admissions at a tertiary level hospital in namibia a retrospective cohort study |
| url | http://dx.doi.org/10.1155/2023/1978536 |
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