Early Mortality and Associated Factors among Patients with Stroke Admitted to a Large Teaching Hospital in Tanzania

• Published in: Journal of stroke and cerebrovascular diseases 2017-04, Vol.26 (4), p.871-878
• Main Authors: Okeng'o, Kigocha, MD, MMed Int.Med, Msc Neuro, Chillo, Pilly, MD, Mmed Int.Med, PhD, Gray, William K., PhD, Walker, Richard W., MD, Matuja, William, MBChB, MRCP, MRCPsy
• Format: Article
• Language: English
• Subjects: Adult; Age Distribution; Aged; Aged, 80 and over; aspiration pneumonia; Cardiovascular; case fatality; Female; Follow-Up Studies; Hospitals, Teaching; Humans; Male; Middle Aged; mortality; Neurology; Physical Examination; Retrospective Studies; stroke; Stroke - epidemiology; Stroke - mortality; sub-Saharan Africa; Tanzania; Tanzania - epidemiology
• ISSN: 1052-3057; 1532-8511
• DOI: 10.1016/j.jstrokecerebrovasdis.2016.10.037

Background Stroke is a major cause of death worldwide and 85.5% of stroke deaths occur in low- and middle-income countries due to stroke. The aim of this study was to investigate correlates and predictors of 30-day mortality in stroke patients in urban Tanzania. Methods A prospective 30-day follow-up study was conducted at the Muhimbili National Hospital, Dar es Salaam, Tanzania. We recruited all patients with stroke seen at the Emergency Medicine Department and medical wards. Patients underwent medical history and physical examination including full neurological examination. For those who met the criteria for the diagnosis of stroke according to the World Health Organization, further data were collected, including cholesterol, creatinine, fasting blood glucose, full blood picture, human immunodeficiency virus serology, and electrocardiogram. Patients were followed up at 30 days from the date of stroke onset. The date and the cause of death of those participants who died within 30 days of stroke onset were recorded. Results A total of 224 patients were recruited into the study, with follow-up data available on 186 (83.0%). At 30 days post stroke, 124 patients (66.7%) were still alive. Mortality was significantly higher among stroke patients who were over 65 years of age. Of the 62 who died, 54% died of aspiration pneumonia and 21% of septicemia. Patients with infection were 4.4 times more likely to die than thosewithout ( P  = .001). Conclusions Poststroke mortality rates were high. Many deaths were potentially preventable.