A Prospective Stroke Register in Sierra Leone: Demographics, Stroke Type, Stroke Care and Hospital Outcomes.
A Prospective Stroke Register in Sierra Leone: Demographics, Stroke Type, Stroke Care and Hospital Outcomes.
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DOI：
10.3389/fneur.2021.712060
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发表时间：
2021
影响因子：
3.4
通讯作者：
Sackley CM
中科院分区：
文献类型：
--
作者：
Youkee D;Deen G;Barrett E;Fox-Rushby J;Johnson I;Langhorne P;Leather A;Marshall IJ;O'Hara J;Rudd A;Sama A;Scott C;Thompson M;Wafa H;Wall J;Wang Y;Watkins C;Wolfe C;Lisk DR;Sackley CM
简介：中风是非洲成人死亡的第二大常见原因。本研究报告了塞拉利昂弗里敦的人口统计学、卒中类型、卒中护理和卒中的医院结局。方法：一项前瞻性观察登记研究记录了2019年5月至2020年4月期间所有18岁及以上卒中患者。根据WHO标准定义卒中。Pearson卡方检验用于检查分类变量之间的关联，而非配对t检验用于连续变量。多变量逻辑回归，以解释院内死亡，报告为比值比（OR）和95%置信区间。结果：共登记了385例卒中，其中315例（81.8%）为首次终生事件。平均年龄为59.2岁（SD 13.8），187例（48.6%）为男性。其中327例（84.9%）经CT扫描证实。231例（60.0%）为缺血性，85例（22.1%）为脑内出血，11例（2.9%）为蛛网膜下腔出血，58例（15.1%）为未确定的卒中类型。美国国立卫生研究院卒中量表的中位数为17 [四分位距（IQR）9-25]。出血性中风比缺血性中风更严重，20（IQR 12-26）与13（IQR 7-22）（p < 0.001），发生在较年轻的人群中，平均年龄为52.3（SD 12.0）vs. 61.6（SD 13.8）（p < 0.001），受教育程度较低，为28.2% vs. 40.7%（p = 0.04）。从卒中发作到到达主要转诊医院的中位时间为25小时（IQR 6-73）。一半的病人（50.4%）在到达之前在另一家医疗机构寻求治疗。151例患者在医院死亡（39.5%）。43例死亡发生在到达医院后48小时内，死亡时间中位数为4天（IQR 0-7天）。49.6%的患者有≥1种并发症，98例（25.5%）肺炎和33例（8.6%）尿路感染。男性（OR 3.33，1.65-6.75）、肺炎（OR 3.75，1.82-7.76）、蛛网膜下腔出血（OR 43.1，6.70-277.4）和未确定的卒中类型（OR 6.35，2.17-18.60）与院内死亡风险较高相关。讨论：我们观察到严重中风发生在一个年轻的人群，住院死亡率高。提供循证中风护理的进一步工作对于降低塞拉利昂的中风死亡率至关重要。
Introduction: Stroke is the second most common cause of adult death in Africa. This study reports the demographics, stroke types, stroke care and hospital outcomes for stroke in Freetown, Sierra Leone. Methods: A prospective observational register recorded all patients 18 years and over with stroke between May 2019 and April 2020. Stroke was defined according to the WHO criteria. Pearson's chi-squared test was used to examine associations between categorical variables and unpaired t-tests for continuous variables. Multivariable logistic regression, to explain in-hospital death, was reported as odds ratios (ORs) and 95% confidence intervals. Results: Three hundred eighty-five strokes were registered, and 315 (81.8%) were first-in-a-lifetime events. Mean age was 59.2 (SD 13.8), and 187 (48.6%) were male. Of the strokes, 327 (84.9%) were confirmed by CT scan. Two hundred thirty-one (60.0%) were ischaemic, 85 (22.1%) intracerebral haemorrhage, 11 (2.9%) subarachnoid haemorrhage and 58 (15.1%) undetermined stroke type. The median National Institutes of Health Stroke Scale on presentation was 17 [interquartile range (IQR) 9–25]. Haemorrhagic strokes compared with ischaemic strokes were more severe, 20 (IQR 12–26) vs. 13 (IQR 7–22) (p < 0.001), and occurred in a younger population, mean age 52.3 (SD 12.0) vs. 61.6 (SD 13.8) (p < 0.001), with a lower level of educational attainment of 28.2 vs. 40.7% (p = 0.04). The median time from stroke onset to arrival at the principal referral hospital was 25 hours (IQR 6–73). Half of the patients (50.4%) sought care at another health provider prior to arrival. One hundred fifty-one patients died in the hospital (39.5%). Forty-three deaths occurred within 48 hours of arriving at the hospital, with median time to death of 4 days (IQR 0–7 days). Of the patients, 49.6% had ≥1 complication, 98 (25.5%) pneumonia and 33 (8.6%) urinary tract infection. Male gender (OR 3.33, 1.65–6.75), pneumonia (OR 3.75, 1.82–7.76), subarachnoid haemorrhage (OR 43.1, 6.70–277.4) and undetermined stroke types (OR 6.35, 2.17–18.60) were associated with higher risk of in-hospital death. Discussion: We observed severe strokes occurring in a young population with high in-hospital mortality. Further work to deliver evidence-based stroke care is essential to reduce stroke mortality in Sierra Leone.
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影响因子：
3.7
作者：
Adeloye D
通讯作者：
Adeloye D
影响因子：
9.9
作者：
Adams, HP;Davis, PH;Hansen, MD
通讯作者：
Hansen, MD
影响因子：
11
作者：
BAMFORD, J;SANDERCOCK, P;WADE, D
通讯作者：
WADE, D
非洲中风的流行病学：对现有方法和新方法的系统评价。
DOI：
10.1111/jch.13152
发表时间：
2018-01
期刊：
Journal of clinical hypertension (Greenwich, Conn.)
影响因子：
--
作者：
Owolabi M;Olowoyo P;Popoola F;Lackland D;Jenkins C;Arulogun O;Akinyemi R;Akinyemi O;Akpa O;Olaniyan O;Uvere E;Kehinde I;Selassie A;Gebregziabher M;Tagge R;Ovbiagele B
通讯作者：
Ovbiagele B
影响因子：
3.4
作者：
Cisse, Fode A.;Damien, Charlotte;Naeije, Gilles
通讯作者：
Naeije, Gilles