Characteristics and outcomes of stroke at Tikur Anbessa Teaching Hospital, Ethiopia

Abstract

Hospital studies have shown that stroke is an important cause of hospital morbidity and mortality in Ethiopia. The aim of this study is to determine the pattern, risk factors and determinants of mortality in patients with clinical diagnosis of stroke. It is a cross sectional study of all patients admitted with a clinical diagnosis of stroke between September 2000 and August 2001 to the Addis Ababa University Teaching Hospital. A total of 128 patients with mean age of 53.2 and M: F ratios of 1.5:1 were admitted The hospital burden of stroke appears to have increased significantly over the past three decades. Hemorrhagic stroke was the most common cause of stroke accounting for 57% of all patients and 59.2% among those who had CT scan. The number of patients with stroke increased linearly until age group 55-64, with peak incidence in the age group 55-64 years accounting for a third of all admissions. Hypertension was the most frequent risk factor identified followed by cardiac disease, 65.6% and 22.7% respectively. The majority of hypertensive patients were either on no form of treatment (28.9%) or erratic and irregular treatments (38.3%). Valvular heart disease (VHD) accounted for 40% of all heart diseases, and almost half of these also had atrial fibrillation of which none were on treatment. The overall mortality was 44.5%. Altered mental state and non focal neurologic deficits were the only independent predictors of mortality, odds ratio (95% CI), 5.7 (2.8-11.6) P = 0.001 and 5.5 (1.6-19.2) P=0.008 respectively. Treatment of hypertension and educating health-care professionals and the public on strategies of primary and secondary prevention remains the most important tool to prevent stroke in Ethiopia. Intensive care and inpatient facilities at referral hospitals have to be improved to curb the high mortality.