Minimal Setting Stroke Unit in a Sub-Saharan African Public Hospital
Minimal Setting Stroke Unit in a Sub-Saharan African Public Hospital
复制标题
DOI：
10.3389/fneur.2019.00856
复制
发表时间：
2019-08-07
影响因子：
3.4
通讯作者：
Naeije, Gilles
中科院分区：
文献类型：
--
作者：
Cisse, Fode A.;Damien, Charlotte;Naeije, Gilles
简介：撒哈拉以南非洲（SSA）的卒中患病率沿着最高，病死率高达40%。我们的目的是评估SSA公立医院最小设置卒中单元对卒中死亡率和主要内科并发症的影响。材料与方法：本研究设置在几内亚科纳克里的伊尼亚斯迪恩公立转诊医院。临床特征、住院死亡率和主要内科卒中并发症发生率（肺炎、尿路感染、溃疡和静脉血栓栓塞），将血压和血氧饱和度监测以及便携式制氧机（POST）与卒中单元创建（PRE）前入院的相似数量的卒中患者进行比较。卒中前（n = 318）和卒中后（n = 361），患者的年龄相当（61 +/- 14 vs. 60 +/- 14.8岁，p = 0.24），性别（56 vs. 50%男性，p = 0.09），高血压发生率（76.7 vs. 79%，p = 0.44）、卒中亚型（72 vs. 78%的病例为缺血性，p = 0.05）和NIHSS（11 +/- 4 vs. 11 +/- 4，p = 0.85）。糖尿病在PRE组中更常见（19 vs. 9%，p < 0.001）。POST组的死亡率显著较低（7.2 vs. 22.3%，p < 0.0001），医疗并发症（4.1 vs. 27.7%，p < 0.001）和肺炎发生率较低（3.3 vs. 14.5%，p < 0.001）。结论：最低装备的卒中单元显著降低了SSA的卒中死亡率和主要医疗并发症。
Introduction: Sub-Saharan Africa (SSA) has the highest stroke prevalence along with a case fatality that amounts to 40%. We aimed to assess the effect of a minimal setting stroke unit in SSA Public hospital on stroke mortality and main medical complications.Materials and Methods: The study was set in Conakry, Guinea, Ignace Deen public referral hospital. Clinical characteristics, hospital mortality and main medical stroke complications rates (pneumonia, urinary tract infections, sores and venous thromboembolism) of admitted stroke patients after the installation of a minimal stroke unit equipped with heart rate, blood pressure and blood oxygen saturation monitoring and portable oxygen concentrator (POST) were compared to a similar number of stroke patients admitted before the stroke unit creation (PRE).Results: PRE (n = 318) and POST (n = 361) stroke, patients were comparable in term of age (61 +/- 14 vs. 60 +/- 14.8 years, p = 0.24), sex (56 vs. 50% males, p = 0.09), High blood pressure rate (76.7 vs. 79%, p = 0.44), stroke subtype (ischemic in 72 vs. 78% of cases, p = 0.05) and NIHSS (11 +/- 4 vs. 11 +/- 4, p = 0.85). Diabetes was more frequent in the PRE group (19 vs. 9%, p < 0.001). Mortality was significantly lower in the POST group (7.2 vs. 22.3%, p < 0.0001) as well as medical complications (4.1 vs. 27.7%, p < 0.001) and lower pneumonia rate (3.3 vs. 14.5%, p < 0.001).Conclusions: Minimally equipped stroke units significantly reduce stroke mortality and main medical complications in SSA.