Risk factors and outcomes of hospitalized stroke patients in Lusaka, Zambia.
Risk factors and outcomes of hospitalized stroke patients in Lusaka, Zambia.
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DOI：
10.1016/j.jns.2021.117404
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发表时间：
2021-05-15
影响因子：
4.4
通讯作者：
Saylor D
中科院分区：
文献类型：
--
作者：
Nutakki A;Chomba M;Chishimba L;Zimba S;Gottesman RF;Bahouth MN;Saylor D
关于包括赞比亚在内的撒哈拉以南非洲国家中风风险因素和结局的数据有限。我们的目的是通过描述赞比亚卢萨卡的国家转诊医院大学教学医院（UTH）住院中风患者的特征来填补这一空白。我们对2018年10月至2019年3月期间在UTH住院神经病学服务中住院的连续中风成人进行了回顾性研究。根据CT扫描结果将卒中分类为缺血性或出血性，如果未获得CT扫描结果，则分类未知。卡方分析和t检验用于比较不同卒中亚型队列之间的特征。脑卒中成人患者占所有神经科住院患者的43%（n=324），平均年龄为60±18岁，62%的队列为女性。卒中亚型为缺血性58%，出血性28%，未知14%。80%的卒中患者存在高血压，且与出血性卒中显著相关（p=0.03）。艾滋病毒存在于18%的所有中风，并没有显着差异，中风亚型。糖尿病（16%）、心脏病（34%）、房颤（9%）和既往卒中史（22%）在缺血性卒中患者中均明显更常见（p<0.05）。住院死亡率总体为24%，出血性卒中患者死亡率最高（33%，p=0.005）。这个赞比亚卒中队列以其年轻、显著的HIV负担、高住院死亡率和高不受控制的高血压率而闻名。我们的结果表明赞比亚的中风负担很大，艾滋病毒对中风有重大贡献，并且需要改善中风的一级预防。
Limited data exists about stroke risk factors and outcomes in sub-Saharan African countries, including Zambia. We aim to fill this gap by describing features of hospitalized stroke patients at University Teaching Hospital (UTH), the national referral hospital in Lusaka, Zambia. We conducted a retrospective study of consecutive adults with stroke admitted to UTH’s inpatient neurology service from October 2018 to March 2019. Strokes were classified as ischemic or hemorrhagic based on CT scan results and unknown if CT scan was not obtained. Chi-square analyses and t-tests were used to compare characteristics between cohorts with differing stroke subtypes. Adults with stroke constituted 43% (n=324) of all neurological admissions, had an average age of 60±18 years, and 62% of the cohort was female. Stroke subtypes were 58% ischemic, 28% hemorrhagic, and 14% unknown. Hypertension was present in 80% of all strokes and was significantly associated with hemorrhagic stroke (p=0.03). HIV was present in 18% of all strokes and did not significantly differ by stroke subtype. Diabetes (16%), heart disease (34%), atrial fibrillation (9%), and past medical history of stroke (22%) were all significantly more common in patients with ischemic stroke (p<0.05). In-hospital mortality was 24% overall and highest among individuals with hemorrhagic strokes (33%, p=0.005). This Zambian stroke cohort is notable for its young age, significant HIV burden, high in-hospital mortality, and high rates of uncontrolled hypertension. Our results demonstrate Zambia’s substantial stroke burden, significant contribution of HIV to stroke, and the need to improve primary stroke prevention.
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DOI：
10.1016/s1474-4422(17)30299-5
发表时间：
2017-11
期刊：
The Lancet. Neurology
影响因子：
--
作者：
GBD 2015 Neurological Disorders Collaborator Group
通讯作者：
GBD 2015 Neurological Disorders Collaborator Group
影响因子：
8.3
作者：
Heuschmann, Peter U.;Di Carlo, Antonio;Wolfe, Charles D. A.
通讯作者：
Wolfe, Charles D. A.
影响因子：
9.9
作者：
Dalli, Lachlan L.;Kim, Joosup;Kilkenny, Monique F.
通讯作者：
Kilkenny, Monique F.
影响因子：
0.8
作者：
Gadama, Yohane;Kamtchum-Tatuene, Joseph;Mwandumba, Henry C.
通讯作者：
Mwandumba, Henry C.
影响因子：
8.3
作者：
Kim, Anthony S.;Johnston, S. Claiborne
通讯作者：
Johnston, S. Claiborne