scholarly journals Stroke Event Factors among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Observational Study

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Ginenus Fekadu ◽  
Hunduma Wakassa ◽  
Firew Tekle
Keyword(s):  
Observational Study ◽  
Rural Areas ◽  
Stroke Unit ◽  
Prospective Observational Study ◽  
Medical Center ◽  
Stroke Patients ◽  
Early Management ◽  
Hospital Arrival ◽  
The Mean ◽  
Jimma University

Background. The fact that the majority of patients come late creates management difficulties as these first hours are important to avoid secondary insults to the brain and preserve the ischemic penumbra. Although thrombolytic treatments are currently not available in our hospital, significant delays during the prehospital or in-hospital phases of care create management difficulties and would make such advanced treatments impossible in the future in Ethiopia. Methods. Prospective observational study was carried at stroke unit of Jimma University Medical Center for 4 consecutive months from March 10 to July 10, 2017. Data was cleaned and entered to Epidata version 3.1 and then exported and analyzed using SPSS version 20.0. Results. A total of 116 eligible stroke patients were recruited during the study period with mean age of 55.1±14.0 years, ranging from 23 to 96 years. The majority of stroke patients were males (62.9%) and from rural areas (72.4%). The median time elapsed between the onset of stroke symptoms and arrival to the hospital was 27 hours. Almost half (47.4%) of the patients presented within 24 hours and 26 (22.4%) patients presented to hospital beyond 72 hours. Majority of patients (40.5%) showed severe neurological deficit on admission and the mean National Institute of health stroke scale (NIHSS) was 15.71 ± 7.52. The mean Glasgow coma scale (GCS) was moderate (12.12±3.35). On hospital arrival systolic blood pressure (SBP) was highly elevated (≥140 mm Hg) in 65.5% of the patients. The circadian pattern showed a significant peak in morning for hemorrhagic stroke (35.7%) and afternoon for ischemic stroke (38.3%). Conclusions. The delay of hospital arrival was a challenge similar to other high income countries for early management of the patients. Studies that attempt to determine some of the factors that impede timely presentation in patients with strokes are advisable to address those issues further.

scholarly journals Burden, Clinical Outcomes and Predictors of Stroke in Hospital Mortality among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Cohort Study

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Legese Chelkeba ◽  
Ayantu Kebede
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Stroke Unit ◽  
Medical Center ◽  
Hospital Arrival ◽  
Time To Death ◽  
The Mean ◽  
Jimma University

Abstract Background: Global burden of stroke epidemiology is changing rapidly. Over the 1990–2013 period, there was a significant increase in the absolute number of deaths and incident events of stroke. The burden of ischemic and hemorrhagic stroke varies between regions and over time in Ethiopia. The paucity of data has limited research output and consequently the response to this burden. Methods: Prospective cohort study was carried at stroke unit of Jimma University Medical Center from March 10- July 10, 2017. The outcome of interest was mortality and time to death. Data was analyzed using SPSS version 20. Multivariable Cox regression was used to identify the predictors of in hospital mortality and time to death from hospital arrival. Predictors with P< 0.05 was considered statistically significant. Results: A total of 116 eligible stroke patients were followed during the study period with the mean age of the patients was 55.1+14.0 years. Stroke accounted for 16.5 % of total medical admissions and 23.6 % of the total cases of in hospital mortality. A total of 91 (78.4%) of patients were discharged being alive making in hospital mortality of rate of 25 (21.6%). The mean time of in hospital mortality after admission was 4.38+3.The prominent suspected immediate cause for in hospital mortality was increased intracranial pressure 17 (68.0%). The mean length of hospital stay was 9.21+6.82days. Brain edema (AHR: 6.27, 95% CI: 2.50-15.76), urine incontinence (AHR: 3.48, 95% CI: 1.48-8.17), National Institute of Health Stroke Scale (NIHSS) >13 during hospital arrival (AHR: 22.58, 95% CI: 2.95-172.56) and diagnosis of stroke clinically alone (AHR: 4.96, 95% CI: 1.96-12.54) were the independent predictors of in hospital mortality. Conclusions: The mortality of stroke in this set up is similar to other low- and middle-resource countries. There should be burning need to establishing and strengthening the available stroke unit which are well-equipped and staffed intensive care units in different hospitals across the country is necessary.

scholarly journals Burden, clinical outcomes and predictors of time to in hospital mortality among adult patients admitted to stroke unit of Jimma university medical center: a prospective cohort study

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Legese Chelkeba ◽  
Ayantu Kebede
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Stroke Unit ◽  
Medical Center ◽  
Stroke Patients ◽  
Hospital Arrival ◽  
Time To Death ◽  
Jimma University

Abstract Background: The global burden of stroke epidemiology is changing rapidly. Over the 1990–2013 periods, there was a significant increase in the absolute number of deaths and incident events of stroke. The burden of stroke varies in Ethiopia between regions and over time. Hence, this study was aimed to assess the burden, clinical outcomes and predictors of time to in hospital mortality among stroke patients. Methods: A prospective cohort study was carried at stroke unit of Jimma University Medical Center (JUMC) from March 10- July 10, 2017. The outcome of interest was mortality and time to death. Data was analyzed using SPSS version 20. Multivariable Cox regression was used to identify the predictors of in hospital mortality and time to death from hospital arrival. Predictor variables with P< 0.05 was considered statistically significant. Results: A total of 116 eligible stroke patients were followed over 4 months. The mean age of patients was 55.1+14.0 years and males comprised of 73 (62.9%). Stroke accounted for 16.5 % of total medical admissions. Among the 116 patients with stroke, 91 (78.4%) were discharged alive making in hospital mortality of rate of 25 (21.6%). The median time of in hospital mortality and length of hospital stay after admission of the patients were 4.38 days and 9.21 days, respectively. The prominent suspected immediate cause for in hospital mortality was increased intracranial pressure in 17 (68.0%) followed by respiratory failure secondary to aspiration pneumonia in 11 (44.0%) patients. Brain edema (AHR: 6.27, 95% CI: 2.50-15.76), urine incontinence (AHR: 3.48, 95% CI: 1.48-8.17), National Institute of Health Stroke Scale (NIHSS) >13 during hospital arrival (AHR: 22.58, 95% CI: 2.95-172.56) and diagnosis of stroke clinically alone (AHR: 4.96, 95% CI: 1.96-12.54) were the independent predictors of time to in hospital mortality. Conclusions: The mortality rate of stroke in this setup was comparable with other low- and middle-income countries (LMICs). There is an urgent need to establish well equipped and staffed stroke units in the country in addition to strengthen the already existing on. Furthermore, future work must be designed to identify the barriers to improve stroke outcomes and recovery.

scholarly journals Burden, clinical outcomes and predictors of time to in hospital mortality among adult patients admitted to stroke unit of Jimma university medical center: a prospective cohort study

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Legese Chelkeba ◽  
Ayantu Kebede
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Clinical Outcomes ◽  
Prospective Cohort ◽  
Stroke Unit ◽  
Medical Center ◽  
Stroke Patients ◽  
Hospital Arrival ◽  
Time To Death ◽  
Jimma University

Abstract Background: The global burden of stroke epidemiology is changing rapidly. Over the 1990–2013 periods, there was a significant increase in the absolute number of deaths and incident events of stroke. The burden of stroke varies in Ethiopia between regions and over time. Hence, this study was aimed to assess the burden, clinical outcomes and predictors of time to in hospital mortality among stroke patients. Methods: A prospective cohort study was carried at stroke unit of Jimma University Medical Center (JUMC) from March 10- July 10, 2017. The outcome of interest was mortality and time to death. Data was analyzed using SPSS version 20. Multivariable Cox regression was used to identify the predictors of in hospital mortality and time to death from hospital arrival. Predictor variables with P< 0.05 was considered statistically significant. Results: A total of 116 eligible stroke patients were followed over 4 months. The mean age of patients was 55.1+14.0 years and males comprised of 73 (62.9%). Stroke accounted for 16.5 % of total medical admissions. Among the 116 patients with stroke, 91 (78.4%) were discharged alive making in hospital mortality of rate of 25 (21.6%). The median time of in hospital mortality and length of hospital stay after admission of the patients were 4.38 days and 9.21 days, respectively. The prominent suspected immediate cause for in hospital mortality was increased intracranial pressure in 17 (68.0%) followed by respiratory failure secondary to aspiration pneumonia in 11 (44.0%) patients. Brain edema (AHR: 6.27, 95% CI: 2.50-15.76), urine incontinence (AHR: 3.48, 95% CI: 1.48-8.17), National Institute of Health Stroke Scale (NIHSS) >13 during hospital arrival (AHR: 22.58, 95% CI: 2.95-172.56) and diagnosis of stroke clinically alone (AHR: 4.96, 95% CI: 1.96-12.54) were the independent predictors of time to in hospital mortality. Conclusions: The mortality rate of stroke in this setup was comparable with other low- and middle-income countries (LMICs). There is an urgent need to establish well equipped and staffed stroke units in the country in addition to strengthen the already existing on. Furthermore, future work must be designed to identify the barriers to improve stroke outcomes and recovery.

scholarly journals Drug-related problems and its determinant among hospitalized neonates with sepsis at Jimma University Medical Center, Ethiopia: a prospective observational study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Mengist Awoke ◽  
Tsegaye Melaku ◽  
Mohammed Beshir
Keyword(s):  
Drug Therapy ◽  
Observational Study ◽  
Neonatal Intensive Care ◽  
Prospective Observational Study ◽  
Medical Center ◽  
Clinical Pharmacy Service ◽  
Drug Related Problems ◽  
Combined Use ◽  
Jimma University ◽  
Neonatal Population

Abstract Background Neonatal populations are quite susceptible to drug-related problems (DRPs) because of clinical heterogeneity and clinical practice trends. However, studies reporting DRPs in the neonatal population are quite limited. Objective This study aimed to assess the magnitude and types of DRPs and determinant factors among neonates admitted with neonatal sepsis at the Neonatal Intensive Care Unit (NICU) of the Jimma University Medical Center (JUMC), Ethiopia. Methods A hospital-based prospective observational study was conducted involving 201 neonates with sepsis admitted to the NICU from May to August 30, 2018. DRPs were classified using Cipolle’s classification method. Statistical Package for Social Science Version 22 was employed for data analysis. Logistical regression was carried out to determine the determinants of DRPs. A p-value < 0.05 was considered to be statistically significant. Results Of 201 neonates with sepsis included in this study, 125 (62.2%) were males and the median age of the neonate was 5 days. The mean (±standard deviation) number of medications taking during their hospital stay was 2.6 ± 0.7. DRPs were identified in 98 neonates, at a rate of 48.8% (95% CI, 41.7–55.9). Dose too high (42, 35.8%) and need additional drug therapy (40, 34.1%) were the commonly identified DRPs. Taking antibiotics plus other medications (Adjusted Odds Ratio (AOR) =5.2, 95%CI [1.2–22.0], p = 0.02) was a determinant factor for the occurrence of DRPs. Conclusion The burdens of DRPs occurrence were high in hospitalized neonates with sepsis. The most common DRPs identified were dose too high and need additional drug therapy. Combined use of other medicines with antibiotics was a predictor of DRP occurrence. The innovative way to tackle the occurrence of DRPs, such as the incorporation of clinical pharmacy service provider into the neonatal care team, which will prevent, detect and/or minimize the occurrence of DRPs, is highly recommended.

scholarly journals Burden, Clinical Outcomes and Predictors of Stroke in Hospital Mortality among Adult Patients Admitted to Stroke Unit of Jimma University Medical Center: Prospective Cohort Study

2019 ◽  
Author(s):  
Ginenus Fekadu ◽  
Legese Chelkeba ◽  
Ayantu Kebede
Keyword(s):  
Cohort Study ◽  
Hospital Mortality ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Stroke Unit ◽  
Medical Center ◽  
Female Ratio ◽  
Hospital Arrival ◽  
Time To Death ◽  
Jimma University

Abstract Background: Global burden of stroke epidemiology is changing rapidly. Over the 1990–2013 period, there was a significant increase in the absolute number of deaths and incident events of stroke. The burden of ischemic and hemorrhagic stroke varies between regions and over time in Ethiopia. The paucity of data has limited research output and consequently the response to this burden in our country. Methods: Prospective cohort study was carried at stroke unit of Jimma University Medical Center (JUMC) from March 10- July 10, 2017. The outcome of interest was mortality and time to death. Data was analyzed using SPSS version 20. Multivariable Cox regression was used to identify the predictors of in hospital mortality and time to death from hospital arrival. Predictor variables with P< 0.05 were considered statistically significant. Results: A total of 116 eligible stroke patients were followed with the mean age of 55.1+14.0 years and males comprised of 73 (62.9%) with male: female ratio of 1.70:1. Stroke accounted for 16.5 % of total medical admissions and 23.6 % of the total cases of in hospital mortality. A total of 91 (78.4%) of patients were discharged being alive making in hospital mortality of rate of 25 (21.6%). The median time of in hospital mortality after admission and length of hospital stay of the patients was 4.38 days and 9.21 days, respectively. The prominent suspected immediate cause for in hospital mortality was increased intracranial pressure 17 (68.0%) followed by respiratory failure secondary to aspiration pneumonia 11 (44.0%). Brain edema (AHR: 6.27, 95% CI: 2.50-15.76), urine incontinence (AHR: 3.48, 95% CI: 1.48-8.17), National Institute of Health Stroke Scale (NIHSS) >13 during hospital arrival (AHR: 22.58, 95% CI: 2.95-172.56) and diagnosis of stroke clinically alone (AHR: 4.96, 95% CI: 1.96-12.54) were the independent predictors of in hospital mortality. Conclusions: The mortality of stroke in this set up was similar to other low- and middle-resource countries. There should be burning need to establish and strengthen the available stroke units which are well-equipped and staffed with intensive health care teams in different hospitals across the country.

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