Profil Kejang Pasca Stroke pada Pasien Rawat Inap Periode Juli 2018 - Juni 2019 di RSUP Prof. Dr. R. D. Kandou Manado

Abstract: Stroke is the most common cause of seizures in elderly population. The higher the number of stroke patients, the higher the predicted level of likelihood of the prevalence of post-stroke seizures. This study was aimed to obtain the profile of post-stroke seizures among hospitalized patients from July 2018 to June 2019 at Prof. Dr. R. D. Kandou Hospital Manado. This was a descriptive and retrospective study. The results showed 24 patients who met the inclusion criteria. Post-stroke seizures were more common in males than in females. Based on age, most patients with post-stroke seizures were in the age range of 45-54 years. Many post-stroke seizure patients worked as housewives. Most post-stroke seizure patients suffered from focal seizures with impaired awareness. Among patients with post-stroke seizures, the number of patients with ischemic stroke type was higher than of patients with hemorrhagic stroke type. In conclusion, the majority of patients were males, aged 45-54 years, had focal seizures and impaired awareness, as well as ischemic stroke. The most common job of the patients was housewifery.Keywords: stroke, seizures, post-stroke seizures Abstrak: Stroke merupakan penyebab kejang yang paling umum pada populasi lansia. Semakin tinggi data yang menunjukkan jumlah pasien stroke, maka tingkat kemungkinan prevalensi terjadinya kejang pasca stroke juga diprediksi akan meningkat. Penelitian ini bertujuan untuk mengetahui profil kejang pasca stroke pada pasien rawat inap periode Juli 2018-Juni 2019 di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif retrospektif. Hasil penelitian memperoleh 24 pasien yang memenuhi kriteria inklusi. Jumlah pasien kejang pasca stroke lebih banyak pada laki-laki dibandingkan perempuan. Berdasarkan usia pasien kejang pasca stroke terbanyak berada dalam rentang usia 45-54 tahun. Berdasarkan pekerjaan, pasien kejang pasca stroke terbanyak bekerja sebagai ibu rumah tangga. Sebagian besar pasien kejang pasca stroke mengalami kejang fokal dengan kesadaran terganggu. Jumlah pasien kejang pasca stroke dengan tipe stroke iskemik lebih banyak dibandingkan tipe stroke hemoragik. Simpulan penelitian ini ialah mayoritas pasien dengan kejang pasca stroke berjenis kelamin laki-laki, berusia 45-54 tahun, tipe kejang fokal dengan kesadaran terganggu, dan tipe stroke iskemik. Pekerjaan yang terbanyak didapatkan ialah ibu rumah tangga.Kata kunci: stroke, kejang pasca stroke

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Abstract 1122‐000122: The Role of the Venous System in Infarct Burden in Patients with Acute Ischemic Stroke

Stroke: Vascular and Interventional Neurology ◽

10.1161/svin.01.suppl_1.000122 ◽

2021 ◽

Vol 1 (S1) ◽

Author(s):

Shail S Thanki ◽

Elliot Pressman ◽

Shail S Thanki ◽

John D Mayfield ◽

Maximilian J Rabil ◽

...

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

False Negative ◽

Transverse Sinus ◽

Sigmoid Sinus ◽

Venous Sinus ◽

Post Stroke ◽

Number Of Patients ◽

Ct Head

Introduction : Acute ischemic stroke (AIS) is a leading cause of disability internationally. Most therapies focus on intra‐arterial treatment to improve post‐stroke deficits and neurologic status. However, if a relationship between venous anatomy and post‐stroke deficits or infarct size can be shown, then venous augmentation strategies represent a possibility for future interventions as an adjunct to intra‐arterial treatment. Methods : We retrospectively reviewed all ischemic infarcts at our institution that underwent thrombectomy from January 2018 – October 2020. From these, we selected cases that were demonstrated as M1 occlusions on intra‐procedural angiogram and those who had a CT Head obtained within six hours of the patient’s last known normal (LKN). Patients without a CT Head or CT Angiogram of their head were excluded. Using axial and sagittal reconstructed views of 0.9mm slices, cross‐sectional area measurements were taken of the superior sagittal sinus 1cm above the Torcula, in three locations of the ipsilateral and contralateral transverse sinus, in three locations of the ipsilateral and contralateral sigmoid sinus, and of the ipsilateral and contralateral internal jugular vein (IJV) at the external surface of the skull. For the transverse and sigmoid sinuses, the three measurements were averaged together. These measurements were then compared against patient’s Alberta Stroke Program Early CT Score (ASPECTS). Results : 77 patients were identified in the study period. Average ASPECTS was 8.9, ranging from 5–10. There were three patients included with ASPECTS < 6. Average ipsilateral transverse sinus area was 34.4mm ± 3.34, average ipsilateral sigmoid sinus area was 32.8mm ± 2.74, average ipsilateral IJV area was 46.9 mm ± 5.00. Correlation tests to identify relationships between venous sinus area and ASPECTS was unremarkable (ipsilateral transverse sinus p = 0.574, ipsilateral sigmoid sinus p = 0.548, ipsilateral IJV p = 0.798). When assessed as a ratio of ipsilateral venous sinus area to contralateral sinus area to assess correlation with ASPECTS, results were unremarkable (transverse sinus p = 0.891, sigmoid sinus p = 0.292, IJV p = 0.499). Conclusions : Venous sinus size was not found to be predictive or associated with predominantly favorable ASPECTS for strokes found within six hours. We believe this may be due to our cohort lacking significant numbers of patients with low ASPECTS, yielding a false negative result. We are currently expanding this project to include a comparable number of patients with ASPECTS < 6 to determine the role of venous collateral system in infarct progression.

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PRE-ECLAMPSIA

The Professional Medical Journal ◽

10.29309/tpmj/2016.23.02.868 ◽

2016 ◽

Vol 23 (02) ◽

pp. 156-160

Author(s):

Anwar Khan ◽

Hamzullah Khan

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Study Data ◽

Inclusion Criteria ◽

Third Trimester ◽

Serum Leptin ◽

Number Of Patients ◽

Age Range ◽

Study Setting ◽

In Pregnancy

Objectives: To determine the relation of leptin, hypertension and body massindex with pre-eclampsia in the 3rd trimester of pregnancy in a hospital based study. Design:descriptive observational study. Setting: three teaching hospital of Peshawar, Khyber teachinghospital, Hayatabad medical complex and lady reading hospital Peshawar. Duration: June2012-dec 2012. Inclusion criteria: all women in their third trimester without any co-morbidity.Exclusion criteria: were all diabetic and first and 2nd trimester pregnant ladies. Procedure:relevant information on height, weight, body mass index (BMI), pulse, blood pressure and leptinwere recorded on a predesigned questionnaire prepared in accordance with the objectivesof the study. Data was analyzed in MS-Excel. Results: A total of 80 pregnant ladies included.Majority of the patients were in the age range of 17-26 years of age. Maximum number 30(37.5%)of patients were in weight ranging 66-75 kg. We observed maximum number of patients werenormotensive systolic BP 110-130mmHg (47%). About 43% of patients had BP>140mmHg upto 200mmHg. 6% had Diasatolic BP between 130-140mmHg. 23.5% had BMI>32.6. 38% hadBMI between 27.62-32.62. We observed that majority of the patients were in the leptin serumrange of 229.57-329.57. 7.75% had serum leptin level above 329 with a maximum of 829.6in one patient at top in data. Conclusion: Serum leptin level in pregnancy increases in thirdtrimester with a determined relation of serum leptin level with gestaional hypertension and preeclampsia.

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The Lipid Paradox Among Acute Ischemic Stroke Patients-A Retrospective Study of Outcomes and Complications

Medicina ◽

10.3390/medicina55080475 ◽

2019 ◽

Vol 55 (8) ◽

pp. 475 ◽

Cited By ~ 1

Author(s):

Patel ◽

Malik ◽

Dave ◽

DeMasi ◽

Lunagariya ◽

...

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Sampling Strategy ◽

Hemorrhagic Transformation ◽

Nursing Facility ◽

Logistic Regression Models ◽

Post Stroke ◽

Risk Of Death ◽

Number Of Patients

Background and objectives: The Studies have suggested hypercholesterolemia is a risk factor for cerebrovascular disease. However, few of the studies with a small number of patients had tested the effect of hypercholesterolemia on the outcomes and complications among acute ischemic stroke (AIS) patients. We hypothesized that lipid disorders (LDs), though risk factors for AIS, were associated with better outcomes and fewer post-stroke complications. Materials and Method: We performed a retrospective analysis of the Nationwide Inpatient Sample (years 2003–2014) in adult hospitalizations for AIS to determine the outcomes and complications associated with LDs, using ICD-9-CM codes. In 2014, we also aimed to estimate adjusted odds of AIS in patients with LDs compared to patients without LDs. The multivariable survey logistic regression models, weighted to account for sampling strategy, were fitted to evaluate relationship of LDs with AIS among 2014 hospitalizations, and outcomes and complications amongst AIS patients from2003–2014. Results and Conclusions: In 2014, there were 28,212,820 (2.02% AIS and 5.50% LDs) hospitalizations. LDs patients had higher prevalence and odds of having AIS compared with non-LDs. Between 2003–2014, of the total 4,224,924 AIS hospitalizations, 451,645 (10.69%) had LDs. Patients with LDs had lower percentages and odds of mortality, risk of death, major/extreme disability, discharge to nursing facility, and complications including epilepsy, stroke-associated pneumonia, GI-bleeding and hemorrhagic-transformation compared to non-LDs. Although LDs are risk factors for AIS, concurrent LDs in AIS is not only associated with lower mortality and disability but also lower post-stroke complications and higher chance of discharge to home.

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Changes in clinical features and outcomes in three major critical diseases after COVID-19 pandemic: acute myocardial infarction, stroke, and cardiac arrest

10.22514/sv.2021.250 ◽

2021 ◽

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Arrest ◽

Ischemic Stroke ◽

Hospital Mortality ◽

Hemorrhagic Stroke ◽

Moving Average ◽

Multivariable Logistic Regression Analysis ◽

Number Of Patients ◽

Post Period

A few months after the onset of the coronavirus Disease 2019 (COVID-19) pandemic, the worse prognoses of acute myocardial infarction, ischemic and hemorrhagic stroke, and cardiac arrest were reported. This study aimed to investigate the changes in the characteristics and prognoses of these diseases in the emergency department (ED) over a year after pandemic’s onset. This was a retrospective observational study. The year 2019 was defined as the pre-period, while the year from February 2020 to January 2021 was defined as the post-period. Adult patients diagnosed with acute myocardial infarction, ischemic stroke, hemorrhagic stroke, or cardiac arrest during the study period were included. The primary outcome was in-hospital mortality. Time series analyses using autoregressive integrated moving average (ARIMA)(p,d,q) model were performed to evaluate the changes between periods. A multivariable logistic regression analysis of factors affecting in-hospital mortality was performed. The proportions of patients with acute myocardial infarction (0.8% vs. 1.1%, p < 0.001), hemorrhagic stroke (1.0%vs. 1.2%, p = 0.011), and cardiac arrest (0.9% vs. 1.1%, p = 0.012) increased in the post-period. The post-period was independently associated with in-hospital mortality in acute myocardial infarction (adjusted odds ratio (aOR) 2.54, 95% confidence interval (95% CI) 1.06–6.08, p = 0.037) and hemorrhagic stroke (aOR 1.74, 95% CI 1.11–2.73, p = 0.016), but not for ischemic stroke or cardiac arrest. Over a year after onset of the COVID-19 pandemic in Korea, the number of patients with acute myocardial infarction, hemorrhagic stroke, and cardiac arrest in the ED increased. An independent association between the post-period and mortality was observed for acute myocardial infarction, and hemorrhagic stroke. This study provides important information for future studies and policies.

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Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.698988 ◽

2021 ◽

Vol 13 ◽

Author(s):

Xuan Qiu ◽

Nan Sheng Han ◽

Jie Xiao Yao ◽

Fang Rui Yu ◽

Yan Yan Lin ◽

...

Keyword(s):

Propensity Score ◽

Sample Size ◽

Lower Risk ◽

Cox Regression ◽

Acupuncture Treatment ◽

Stroke Patients ◽

Confidential Interval ◽

Post Stroke ◽

Number Of Patients ◽

Stroke Type

Background: Post-stroke insomnia (PSI) affects the quality of life for stroke patients, reduces the likelihood of successful rehabilitation, and produces additional complications following stroke. Previous reports have provided some information regarding PSI risk factors, but little is known concerning protective factors for PSI. This study analyzed the relationship between acupuncture and insomnia in stroke patients and explored the use of acupuncture as a preventive treatment.Methods: Patients diagnosed with stroke from 2010 to 2019 were identified in the case database of the First Affiliated Hospital of Guangzhou University of Chinese These patients followed until 2020, and numerous factors were examined, including gender, age, stroke type, stroke location, and baseline comorbidities. A 1:1 propensity score was used to match an equal number of patients receiving acupuncture with stroke patients who did not receive acupuncture (N = 1,680 for each group). The purpose of the study was to compare the incidence of insomnia in these two stroke cohorts. We used the Cox regression model and Kaplan-Meier method to estimate the risk of insomnia as the outcome event.Results: Compared with the non-acupuncture cohort in general, stroke patients who received acupuncture treatment exhibited a lower risk of insomnia after adjusting for age, gender, stroke type, stroke location, and comorbidities (adjusted hazard ratio HR = 0.27, 95% confidential interval = 0.23 to 0.32). Acupuncture also reduced the risk of PSI for both genders. The respective risks were HR = 0.28 (adjusted) for males and HR = 0.26 (adjusted) for females. Acupuncture also lowered the risk for PSI for different age groups. The risks were HR = 0.22 (adjusted) for individuals 18 to 39 years of age, HR = 0.31 (adjusted) for individuals 40 to 59 years of age, HR = 0.28 (adjusted) for those 60 to 79 years of age, and HR = 0.18 (adjusted) for individuals 80 years of age and older. Concerning the stroke type, regardless of whether the stroke was ischemic, hemorrhagic, or a combination of the two stroke types, patients who received acupuncture exhibited lower risk (adjusted HR = 0.28, 0.17, and 0.49, respectively). Concerning stroke location, except for the cerebral hemispheres (adjusted HR = 1.10, 95% confidential interval = 0.12 to 1.01), the risk of PSI after receiving acupuncture was lower for the frontal lobe (adjusted HR = 0.42), the basal ganglia (adjusted HR = 0.22), the radiation crown (adjusted HR = 0.42), the diencephalon (adjusted HR = 0.20), or multiple partial strokes (adjusted HR = 0.26), the risk of PSI after receiving acupuncture was lower. For all baseline complications, acupuncture reduced the risk of insomnia. The cumulative incidence of insomnia in the acupuncture cohort was significantly lower than the non-acupuncture cohort (log-rank test, P = 0.000).Limitations: First, our research only included patients from a single center. Second, we did not classify the post-stroke insomnia severity. Second, the information was extracted manually. Overall, the sample size was small, and we needed to increase the sample size to strengthen the conclusions.Conclusion: Acupuncture treatment reduced the risk of insomnia in stroke patients. Future research be conducted with increased sample sizes and further elaboration on the specific acupuncture protocols that were used.

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The decrease in hospitalizations for transient ischemic attack and ischemic stroke, especially in mild cases, during the COVID-19 epidemic in Japan

10.1101/2020.11.17.20233692 ◽

2020 ◽

Author(s):

Hiroyuki Nagano ◽

Daisuke Takada ◽

Jung-ho Shin ◽

Tetsuji Morishita ◽

Susumu Kunisawa ◽

...

Keyword(s):

Ischemic Stroke ◽

Transient Ischemic Attack ◽

Hemorrhagic Stroke ◽

Hospital Admissions ◽

Health Care Systems ◽

Number Of Patients ◽

Stroke Diagnosis ◽

Before And After ◽

Ischemic Attack ◽

The Impact

AbstractBackground and PurposeThe epidemic of the coronavirus disease 2019 (COVID-19) has affected health care systems globally. The aim of our study was to assess the impact of the COVID-19 epidemic on hospital admissions for stroke in Japan.MethodsWe analyzed administrative (Diagnosis Procedure Combination) data for cases of inpatients aged 18 years and older who were diagnosed with stroke (ischemic stroke, transient ischemic attack (TIA), hemorrhagic stroke, or subarachnoid hemorrhage (SAH)) and discharged from hospital during the period July 1, 2018 to June 30, 2020. The number of patients with each stroke diagnosis, various patient characteristics, and treatment approaches were compared before and after the epidemic. Changes in the trend of the monthly number of inpatients with each stroke diagnosis were assessed using interrupted time-series analyses.ResultsA total of 111,922 cases (ischemic stroke: 74,897 cases; TIA: 5,374 cases; hemorrhagic stroke: 24,779 cases; SAH: 6,872 cases) in 253 hospitals were included. The number of cases for all types of stroke decreased (ischemic stroke: -13.9%; TIA: -21.4%; hemorrhagic stroke: -9.9%; SAH: -15.2%) in April and May 2020, compared to the number of cases in 2019. Ischemic stroke and TIA cases, especially mild cases (modified Rankin Scale = 0), decreased, with a statistically significant change in trend between the before- and after-epidemic periods.ConclusionsThese data showed a marked reduction in the number of hospital admissions due to stroke during the COVID-19 epidemic. The change in Ischemic stroke and TIA cases, especially mild cases, was statistically significant.

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Accuracy of identifying incident stroke cases from linked health care data in UK Biobank

Neurology ◽

10.1212/wnl.0000000000009924 ◽

2020 ◽

Vol 95 (6) ◽

pp. e697-e707 ◽

Cited By ~ 1

Author(s):

Kristiina Rannikmäe ◽

Kenneth Ngoh ◽

Kathryn Bush ◽

Rustam Al-Shahi Salman ◽

Fergus Doubal ◽

...

Keyword(s):

Primary Care ◽

Ischemic Stroke ◽

Hospital Admission ◽

Hemorrhagic Stroke ◽

Large Population ◽

Population Based ◽

Uk Biobank ◽

Electronic Patient Records ◽

Death Record ◽

Stroke Type

ObjectiveIn UK Biobank (UKB), a large population-based prospective study, cases of many diseases are ascertained through linkage to routinely collected, coded national health datasets. We assessed the accuracy of these for identifying incident strokes.MethodsIn a regional UKB subpopulation (n = 17,249), we identified all participants with ≥1 code signifying a first stroke after recruitment (incident stroke-coded cases) in linked hospital admission, primary care, or death record data. Stroke physicians reviewed their full electronic patient records (EPRs) and generated reference standard diagnoses. We evaluated the number and proportion of cases that were true-positives (i.e., positive predictive value [PPV]) for all codes combined and by code source and type.ResultsOf 232 incident stroke-coded cases, 97% had EPR information available. Data sources were 30% hospital admission only, 39% primary care only, 28% hospital and primary care, and 3% death records only. While 42% of cases were coded as unspecified stroke type, review of EPRs enabled a pathologic type to be assigned in >99%. PPVs (95% confidence intervals) were 79% (73%–84%) for any stroke (89% for hospital admission codes, 80% for primary care codes) and 83% (74%–90%) for ischemic stroke. PPVs for small numbers of death record and hemorrhagic stroke codes were low but imprecise.ConclusionsStroke and ischemic stroke cases in UKB can be ascertained through linked health datasets with sufficient accuracy for many research studies. Further work is needed to understand the accuracy of death record and hemorrhagic stroke codes and to develop scalable approaches for better identifying stroke types.

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Predictors of 30-day and 90-day mortality among hemorrhagic and ischemic stroke patients in urban Uganda: a prospective hospital-based cohort study

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01724-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Gertrude Namale ◽

Onesmus Kamacooko ◽

Anthony Makhoba ◽

Timothy Mugabi ◽

Maria Ndagire ◽

...

Keyword(s):

Cohort Study ◽

Ischemic Stroke ◽

Acute Phase ◽

Hemorrhagic Stroke ◽

Functional Disability ◽

Stroke Severity ◽

Protective Effects ◽

Stroke Patients ◽

Post Stroke ◽

Gcs Score

Abstract Background We report here on a prospective hospital-based cohort study that investigates predictors of 30-day and 90-day mortality and functional disability among Ugandan stroke patients. Methods Between December 2016 and March 2019, we enrolled consecutive hemorrhagic stroke and ischemic stroke patients at St Francis Hospital Nsambya, Kampala, Uganda. The primary outcome measure was mortality at 30 and 90 days. The modified Ranking Scale wasused to assess the level of disability and mortality after stroke. Stroke severity at admission was assessed using the National Institute of Health Stroke Scale (NIHSS) and Glasgow Coma Scale (GCS). Examination included clinical neurological evaluation, laboratory tests and brain computed tomography (CT) scan. Kaplan-Meier curves and multivariate Cox proportional hazard model were used for unadjusted and adjusted analysis to predict mortality. Results We enrolled 141 patients; 48 (34%) were male, mean age was 63.2 (+ 15.4) years old; 90 (64%) had ischemic and 51 (36%) had hemorrhagic stroke; 81 (57%) were elderly (≥ 60 years) patients. Overall mortality was 44 (31%); 31 (23%) patients died within the first 30 days post-stroke and, an additional 13 (14%) died within 90 days post-stroke. Mortality for hemorrhagic stroke was 19 (37.3%) and 25 (27.8%) for ischemic stroke. After adjusting for age and sex, a GCS score below < 9 (adjusted hazard ratio [aHR] =3.49, 95% CI: 1.39–8.75) was a significant predictor of 30-day mortality. GCS score < 9 (aHR =4.34 (95% CI: 1.85–10.2), stroke severity (NIHSS ≥21) (aHR = 2.63, 95% CI: (1.68–10.5) and haemorrhagic stroke type (aHR = 2.30, 95% CI: 1.13–4.66) were significant predictors of 90-day mortality. Shorter hospital stay of 7–13 days (aHR = 0.31, 95% CI: 0.11–0.93) and being married (aHR = 0.22 (95% CI: 0.06–0.84) had protective effects for 30 and 90-day mortality respectively. Conclusion Mortality is high in the acute and sub-acute phase of stroke. Low levels of consciousness at admission, stroke severity, and hemorrhagic stroke were associated with increased higher mortality in this cohort of Ugandan stroke patients. Being married provided a protective effect for 90-day mortality. Given the high mortality during the acute phase, critically ill stroke patients would benefit from early interventions established as the post-stroke- standard of care in the country.

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Abstract WP195: Home Time by Stroke Type: a Population-based Study to Evaluate Functional Outcome After a Cerebrovascular Event

Stroke ◽

10.1161/str.48.suppl_1.wp195 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Amy Y Yu ◽

Edwin Rogers ◽

Eric E Smith

Keyword(s):

Ischemic Stroke ◽

Cohort Studies ◽

Functional Outcome ◽

Prospective Cohort ◽

Hemorrhagic Stroke ◽

Community Dwelling ◽

Cerebrovascular Event ◽

Term Care ◽

Prospective Cohort Studies ◽

Stroke Type

Introduction: Home time has been proposed as a surrogate for functional outcome in ischemic stroke, and is also a highly valued patient-centered outcome that reflects resource utilization. In prospective cohort studies and clinical trials, higher home time has been correlated with lower disability; however, the requirement for informed consent results in selection bias. Therefore, the population distributions of home time after stroke are currently unknown. Additionally, home time distributions have not been reported in hemorrhagic stroke and transient ischemic attack (TIA). We developed a novel administrative data algorithm to compare home time distributions after hospital admission for cerebrovascular events in the population of Alberta, Canada. Methods: Home time was defined as the number of nights not spent in an institution, including acute-care, inpatient rehabilitation facilities, and long-term care, in the 90 days after admission for a cerebrovascular event. Community-dwelling residents of Alberta, Canada with a valid healthcare number admitted for a cerebrovascular event between April 2012 and June 2015 were included. We used the Kruskal-Wallis test to compare the median home-times according to stroke type: ischemic stroke (IS), TIA, or hemorrhagic stroke (HS), including intracerebral and subarachnoid hemorrhage. We correlated admitting age and home time with Spearman correlations and assessed sex and home time with Wilcoxon Rank Sum. Results: A total of 12520 admissions were identified, the median age was 74 years (IQR 22), and 53% were male. There were 8482 (68%) IS, 2434 (19%) TIA, and 1604 (13%) HS. The median (IQR) home time by stroke type was 72 nights (85) for IS, 87 nights (6) for TIA, and 29 nights (79) for HS (p<0.001). For each stroke type, lower home time was correlated with higher age (IS: r=-0.35; TIA: r=-0.31; HS: r=-0.33; p<0.001 for each comparison) and female sex (p≤0.001). Conclusion: In this population with universal healthcare access, TIA had the highest home time (i.e. best outcomes) whereas hemorrhagic stroke had the lowest, consistent with expected functional outcomes based on prospective cohort studies. Home time may be a useful metric to track patient outcomes and healthcare utilization based on administrative health data.

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Non-Modifiable Risk Factors (Age and Sex), Stroke Types, and Outcomes in Rivers State, Nigeria: A Retrospective Hospital-Based Study

10.20944/preprints202107.0446.v1 ◽

2021 ◽

Author(s):

Osborne Ikechuckwu Osuegbu ◽

Foluke Olukemi Adeniji ◽

Golden Chukwuemaka Owhonda ◽

Rogers Bariture Kanee ◽

M Alblihed ◽

...

Keyword(s):

Ischemic Stroke ◽

Direct Effect ◽

Structural Equation ◽

Hemorrhagic Stroke ◽

Stroke Patients ◽

Cross Sectional ◽

Stroke Type ◽

Middle Aged Adults ◽

Rivers State ◽

Age And Sex

This study used structural equation modelling (SEM) to evaluate the direct effect of sex and age on stroke types and outcomes in Tertiary Health Facilities in Rives State, Nigeria. The study was a cross-sectional retrospective hospital-based research that utilized specific stroke patients’ information between 2015-2019. The study obtained the sex and age, stroke type (ischemic/hemorrhagic), and outcomes (No disability/disability/death) from the records. The retrieved data was Microsoft Excel (2016), then analyzed using SPSS (version 21, Amos) and STATGRAPHICS centurion (Stat Point Tech., Inc.). From the result, out of the recorded 1916 stroke patients, 1229 (64.1%) were female, while 687 (35.9%) were males. The older adults (>55 years) had more recorded cases (n=1289) than young adults (ages 18–35 years; n=77) and middle-aged adults (ages 36–55 years, n=550). The SEM results showed that age was significantly associated with stroke type (P<0.001) and outcomes (P=0.038), while sex was significantly associated with stroke outcomes (P<0.001). The likelihood of death was 1.3 times higher in hemorrhagic stroke than ischemic stroke. In conclusion, age and sex had direct effects on stroke type, while age had a direct effect on stroke outcome. Hemorrhagic stroke was more likely to cause death than ischemic stroke in the studied population.

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