A Prospective Study of Stroke Characteristics, Risk Factors, and Mortality in a Tertiary Hospital of Northern Ethiopia

Abstract

Background: As developing countries experience the epidemiologic transition to chronic diseases, morbidity and mortality from stroke is expected to rise. Stroke and other non-communicable diseases are increasing in Ethiopia but prospective data are scarce and there are not enough data regarding the characteristics, risk factors and mortality of stroke.

Objective: Aimed at determining the risk factors, clinical profiles and treatment outcomes of stroke admissions in Ayder Comprehensive Specialized Hospital, Tigray, Ethiopia.

Methods: This is a prospective cross-sectional study of all adult stroke patients admitted over consecutive 12 months period in medical ward and ICU of Ayder Comprehensive sSpecialized Hospital, northern Ethiopia. Medical residents through a pre-designed questionnaire collected data. Monovariate analysis, bivariate analysis and multivariate analysis to control for confounder variables were done using software SPSS version 26. P < 0.05 was considered statistically significant.

Results: There were 272 stroke admissions to medical ward and ICU over the 1-year period. Stroke comprised 13.05% of total medical admissions. Ischemic stroke accounted for 62.9% of stroke admissions. Stroke in the young accounted for 14.7% of all stroke admissions. Hypertension was the most common risk factor identified, found in 51.8%. Diabetes mellitus and atrial fibrillation were the other common risk factors. The in-hospital mortality was 13.6%. The only independent predictor of mortality identified was presence of complications, AOR [95% CI] of 2.4 [1.4, 5.3], P-value of 0.028. Aspiration pneumonia was the most common complication.

Conclusion: This study showed a high burden of stroke among medical admissions in northern Ethiopia. Being the most common risk factor for stroke, the high burden of undiagnosed and untreated hypertension needs special attention and efforts on community awareness should be enhanced. The relatively higher mortality illustrates the need to establish stroke centers to enhance the quality of stroke care.

Keywords: hemorrhagic stroke; ischemic stroke; mortality; northern Ethiopia; risk factors.