scholarly journals Pharmacotherapy Pattern and Treatment Outcomes of Stroke Patients Admitted to Jimma University Medical Center, Ethiopia

2021 ◽  
Vol Volume 12 ◽  
pp. 267-275
Author(s):  
Nigatu Beyene ◽  
Korinan Fanta ◽  
Ramanjireddy Tatiparthi
Keyword(s):  
Treatment Outcomes ◽  
Medical Center ◽  
Stroke Patients ◽  
Jimma University

scholarly journals Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Ameha Zeleke Zewudie ◽  
Tolcha Regasa ◽  
Solomon Hambisa ◽  
Dejen Nureye ◽  
Yitagesu Mamo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Stroke Unit ◽  
Hemorrhagic Stroke ◽  
Medical Center ◽  
Stroke Patients ◽  
Poor Treatment ◽  
Poor Treatment Outcome ◽  
Jimma University

Background. Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). Methods. A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome. Results. Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65   adjusted   odd   ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001 ), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001 ), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001 ), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03 ) were independent predictors of poor treatment outcomes. Conclusion. Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).

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 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 Quality of life of obstetrics fistula patients before and after surgical repair in the Jimma University Medical Center, Southwest Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tilahun Fufa Debela ◽  
Zerihun Asefa Hordofa ◽  
Aster Berhe Aregawi ◽  
Demisew Amenu Sori
Keyword(s):  
Quality Of Life ◽  
Surgical Repair ◽  
Obstetric Fistula ◽  
Medical Center ◽  
Mean Value ◽  
Significant Difference ◽  
Before And After ◽  
The Mean ◽  
Jimma University

Abstract Background The consequences of obstetric fistula on affected women are more than the medical condition. It has extensive physical, psychological, social, and economic consequences on them. Obstetric fistula affects the entire health and entire life of women. Women suffering from obstetric fistula are often abandoned by her partner, relatives, and the community. This study aimed to determine the quality of life of obstetrics fistula patients before and after surgical repair. Methods Institutional-based prospective, before and after study design was conducted in the Jimma University Medical Center from November 1, 2019–October 30, 2020. A face-to-face interview was conducted with fistula patients who visited Jimma University Medical center, fistula clinic during the study period. All fistula patients were included in the study. Accordingly, 78 women who underwent surgical repair were interviewed. The means and the standard deviation were computed using conventional statistics formulas. The unpaired t-test was used to compare two independent means, and one-way analysis of variance (ANOVA) was used to compare the quality of life before repair and after a successful repair. Linear regression analysis was done for identifying determinants of quality of life. A P value of 0.05 will be considered statistical significance. Result The overall quality of life of women was 58.17 ± 7.2 before the surgical repair and 71.20 ± 10.79 after surgical repair. The result indicates there is a significant difference in the mean value of pre and post-operative (P < 0.001). The overall satisfaction of women with their health status before the surgical repair was 22.5 ± 1.30and it has increased to 53.0 ± .90after surgical repair. The physical health dimension score was 16.51 ± 5.27 before the surgical repair while it has increased to 21.77 ± 5.38 after the surgical repair. The score of the social domain before the surgical repair was 5.19 ± 1.34 and it has increased to 7.13 ± 3.67 after the surgical repair. The score of the environmental health domain was 17.41 ± 2.89 before the surgery while it also increased to 21.65 ± 4.04 after the surgical repair. The results have shown there was a significant difference in the mean values of pre and post-operatives in both social and environmental scores (P < 0.001). The score of the psychological health domain before the surgery was 19.06 ± 1.46 and it was increased to 19.84 ± 3.21 after the surgical repair. The result showed there is a significant difference in mean value pre and post-operative (P = 0.048), though it is a slight improvement compared to other domains. Conclusion The overall quality of life of the patient with fistula was improved after successful surgical repair. Although all domains of quality of life had shown significant improvement after successful surgical repair, the psychological domain showed slight improvement.

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