A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria
Background: Stroke is a common neurological disorder and is the third leading cause of death and a major cause of long-term disability. The disease is expected to increase in low- and middle-income countries like Nigeria. There is no information on stroke in rural Nigeria. Objectives: To review the...
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Published in | Annals of African medicine Vol. 10; no. 2; p. 80 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
Published |
Nigeria
Annals of African Medicine Society
01.04.2011
Medknow Publications and Media Pvt. Ltd Medknow Publications & Media Pvt. Ltd |
Subjects | |
Online Access | Get full text |
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Summary: | Background: Stroke is a common neurological disorder and is the third
leading cause of death and a major cause of long-term disability. The
disease is expected to increase in low- and middle-income countries
like Nigeria. There is no information on stroke in rural Nigeria.
Objectives: To review the clinical patterns, risk-factors, and outcome
of stroke in a tertiary hospital in rural Nigeria and examine the
rural-urban variation of stroke hospitalization in Nigeria. Materials
and Methods: We carried out a retrospective study of patients who had a
clinical diagnosis of stroke at the Federal Medical Centre, Ido-Ekiti,
South-western Nigeria between November 2006 and October 2009. Results:
A total of 101 patients who had stroke were admitted during this review
period, accounting for 4.5% of medical admission and 1.3% of total
hospital admission. Women accounted 52.5% of cases, with a male to
female ratio of 1 : 1.1. Their mean age was 68 ± 12 years. Stroke
occurrences increased with age, as almost half (49.5%) of the cases
were aged ≥70 years and majority (84.2%) of them were in low
socioeconomic class. The mean hospital stay for stroke treatment was 12
± 9 days, Glasgow coma score on admission was 11 ± 4.
Ischemic stroke was 64.4%; hemorrhagic stroke, 34.7%; and
indeterminate, 1.0%. Hypertension (85.2%), diabetes mellitus (23.8%),
and tobacco smoking (22.8%) were the common identifiable risk factors
for stroke. Of all the patients, 69% had ≥2 risk factors for
stroke. Thirty-day case fatality was 23.8%; it increases with age and
was higher among men than women (29.2 vs 18.9%) and in patients with
diagnosis of hemorrhagic stroke (34.3 vs 18.5%). The numbers of
identifiable risk factors of stroke has no effect on the 30-day case
fatality. When compared with stroke in urban areas of Nigeria, we found
no differences in frequency of hospitalization (1.3 vs 0.9 - 4%) and
the major risk factor (hypertension). Hemorrhagic stroke was more
common in urban than in the rural community (45.2 - 51 vs 34.7%) and
the 30-day case fatality was lower in the rural community (23.8 vs 37.6
- 41.2%). Conclusion: Stroke is also a common neurological condition in
rural Nigeria, in view of the fact that almost 70% of the patients had
≥2 risk factors of stroke. We recommend that, sustainable,
community-friendly intervention programmes are incorporated into the
health care system for the early prevention, recognition, and
modification of the risk factors in persons prone to the disease. |
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ISSN: | 1596-3519 0975-5764 |
DOI: | 10.4103/1596-3519.82061 |