A Seven-Year retrospective review of stroke admissions in Benin-City, Southern Nigeria
DOI:
https://doi.org/10.30442/ahr.0501-2-32Keywords:
Diabetes mellitus, Hypertension, Intra-cerebral haemorrhage, Ischaemic stroke, WHO-Clinical Criteria for StrokeAbstract
Background: Stroke is a significant cause of hospital admissions, disability and mortality, but there is a lack of information on stroke in parts of the southern region of Nigeria.
Objective: To analyze the frequency of stroke admissions, clinical presentations, risk factors, stroke types and outcomes over seven years, in a secondary level hospital in southern Nigeria.
Methods: This was a retrospective study. The hospital record of patients hospitalized between January 2006 and December 2012 at the Central Hospital, Benin-City with the diagnosis of stroke based on the World Health Organization (WHO)-clinical criteria, were studied.
Results: Four hundred and nineteen patients with stroke were hospitalized during the study period; this accounted for 3.1% of all the medical admissions. The mean age was 62.4 ± 13.6 years. There were 222 (53%) males and 197(47.0%) females. Ischaemic stroke occurred among 71% of cases; others included intra-cerebral haemorrhage (26%) and subarachnoid haemorrhage (3.1%). The main presenting features included hemiparesis (69%) and sudden loss of consciousness (27.2%). The risk factors included hypertension (84%) and diabetes mellitus (12.2%). The 7, 14 and 30 days case fatality rates were 21.2%, 25.5% and 30.8% respectively. A higher case fatality rate was recorded in haemorrhagic stroke compared to ischaemic stroke (68.8% vs 24%, p = 0.0001).
Conclusion: Stroke was a significant cause of mortality amongst medical admissions and hypertension was the most common risk factor. Closer attention to the risk factors for stroke may likely help to reduce the burden of stroke.
References
WHO Monica Project, Principal Investigators. The World Health Organization MONICA Project (Monitory Trends and determinants in Cerebrovascular disease): a Major International Collaboration. J Clin Epidermiol 1988; 41: 105-114.
Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, et al. An updated definition of stroke for the 21st century. Stroke 2013; 44: 2064-2089.
Warlow CP, Dennis MS, Van Gijn J, Hankey GT, Sandercock PAG, Bamford JM, et al. Stroke: a practical guide to Management. Oxford: Blackwell Science 1996: 491-493.
O Donnel MJ, Xavier D, Liu l. Risk factors for ischemic and intracerebral hemorrhagic stroke in 22 countries (The Interstroke Study): A case control study. Lancet. 2010; 376: 112-113.
Chukwudelunzu FE, Okwu-Delunzu VU, Dizissah J. Knowledge of Stroke Signs and Symptoms among Residents in a Rural South Eastern Nigerian Community. J Stroke Cerebrovasc Dis 2018; 27: 3306-3310.
Aho K, Harmsen P, Hatano S, Marquadsen J, Smirnov V, Strasser T. CVD in the community: results of WHO collaborative study. Bull World Health Org. 1980; 58: 113-130.
Ogun SA, Oluwole O, Fatade B, Ogunseyinde AO, Ojini FI, Odusote KA. Comparison of the Siriraj Stroke Score and the WHO criteria in the clinical classification of stroke subtypes. Afr J Med Sci 2002; 31: 13-16.
Nor AM, Davis J, Sen B, Shipsey D, Louw SJ, Dyker AG, et al. The Recognition of Stroke in the Emergency Room (ROSIER) Scale development and validation of a stroke recognition instrument. Lancet Neurol 2005: 4(11): 727-734.
Ricc S, Celani MG, Reghetti E. Clinical Methods for diagnostic confirmation of stroke Subtypes. Neuroepidermiol 1994; 13: 290-295.
Ogun S.A. Acute Stroke Mortality at Lagos University Teaching Hospital – a five year review. Niger Q J Hosp Med 2000; 10: 8–10.
Abubakar SA, Sabir AA. Profile of Stroke Patients seen in a tertiary health care center in Nigeria. Ann Niger Med 2013; 7: 55-59.
Ogun SA, Ojini F.I, Ogungbo B, Kolapo KO, Danesi MA. Stroke in South West Nigeria. Stroke 2005; 36(6): 1120–1122.
Obembe AO, Olaogun MO, Bamikole AA, Komalafe MA, Odetunde MO. Awareness of risk factors and warning signs of stroke in a Nigerian University. J Stroke Cerebrovasc. Dis 2014; 23(4): 749–758.
Desalu OO, Wahab KW, Fawale B, Olarenwaju TO, Busari OA, Adekoya AO, et al. A review of stroke admissions at a tertiary hospital in rural South Western Nigeria. Ann Afr Med 2011; 10: 80-85.
Njoku CH, Aduloju AB. Stroke in Sokoto, Nigeria: A five year retrospective study. Ann Afr Med 2004; 3: 73-76.
Ukoha OB, Ajaegbu O, Eke CO. A review of stroke cases in a military Hospital in Nigeria. Afrimedic J 2012; 2: 30-33.
Imarhiagbe FA, Ogbeide E, Ogunrin AO. Adult Stroke Registry in West Africa. Profile of 334 in-patients in the University of Benin Teaching Hospital, Benin City, Nigeria. Sahel Med J 2016; 19: 12–15.
Ojo O, Onyegiri CV. Stroke admissions in Kubwa General Hospital. A 30 month review. Sahel Med 2017; 20: 155–159.
Sacco RL, Benjamin EJ, Broderick JP, Dyken M, Easton JD, Feinberg WM, et al. American Heart Association Prevention Conference, IV: Prevention and rehabilitation of stroke: risk factors. Stroke.1997; 28: 1507-1517.
Sennay AG, Hannah SY. Types, risk profiles, and outcomes of stroke patients in a tertiary teaching hospital in Northern Ethiopia. eNeurologicalSci 2016; 3: 41-47.
Garbusinki JM, Vander Sande MA. Bartholome EJ, Dramaix M, Gaye A, Coleman R, et al. Stroke presentation and outcome in developing countries. A prospective study in the Gambia. Stroke 2005; 36: 1388–1393.
Rosman KD. The epidemiology of stroke in an Urban Black Population. Stroke 1986; 17: 667–669.
Philip MW, Kenndy RL. ABC of arterial and venous disease. BMJ 2000; 320: 920-923.
Hansagi H, Romelsj OA, Gerhardsson de Verdier M, Andreasson S, Leifman A. Alcohol consumption and stroke mortality, a 20 year follow up of 15,077 men and women.. Stroke 1995;26: 1968-1973.
Bamford J, Dennis M, Sanderock P, Burn J, Warlow C. The frequency, causes and timing of death within 30 days of a first stroke. The Oxfordshire community stroke project 1981 – 1986. J Neurol Neurosurg Psychiatry 1990; 53: 967–971.
Bamford J, Sanderock P, Dennis M, Burn J, Warlow C. A prospective study of acute cerebrovascular disease in the community: the Oxford shire community stroke project 1981–1986.2. Incidence, case fatality rates and overall outcome at one year of cerebral infarction, primary intracerebral and subarachnoid hemorrhage. J Neurol Neurosurg Psychiatry 1990; 13: 16 – 22.
Venables G. Prognosis, outcome and recurrence of stroke. Stroke series 2002; 9: 103-105.
Ojini FI, Ogun SA, Danesi MA. Thirty days care fatality of stroke at LUTH. Niger Q J Hosp Med 2004; 14: 64–66.
Wahab KW. The burden of stroke in Nigeria. Int J Stroke 2008; 3: 290-292.
Downloads
Published
Issue
Section
License
The articles and other materials published in the Annals of Health Research are protected by the Nigerian Copyright laws. The journal owns the copyright over every article, scientific and intellectual materials published in it. However, the journal grants all authors, users and researchers access to the materials published in the journal with the permission to copy, use and distribute the materials contained therein only for academic, scientific and non-commercial purposes.
