<div style="text-align:justify;"> <strong>Background:</strong> Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were<span "="">...<div style="text-align:justify;"> <strong>Background:</strong> Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were<span "=""> to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. <b>Methods:</b> This was a hospital-based retrospective cohort</span><span "=""> </span><span "="">which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. <b>Results:</b> The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS < 9 [OR (95% CI) = 3.538 (1.086 - 11.526), p = 0.036] and NIHSS 15 - 24 [OR (95% CI) = 7.498 (1.306 - 43.029), p = 0.024] were independent predictors of in-hospital mortality while mass effect [OR (95% CI) = 3.563 (1.217 - 10.432), p = 0.020] and hyperthermia [OR (95% CI) = 4.645 (1.341 - 16.085), p = 0.015] predict poor functional outcome. Six</span>-<span "="">month survival was 37.8%. <b>Conclusion:</b> About one</span>-<span "="">third of stroke patient were haemorrhagic. Hypertension is the leading CVRF and aetiology of spontaneous ICH. About 1 over 2 patients with SICH would die within 3 months while 50% of survivors would have a poor functional outcome at 6<sup>th</sup> month.</span> </div>展开更多
Background: Post-stroke outcomes are poorer in patients with diabetes mellitus (DM). The aim of this study was to determine the prevalence of DM in acute stroke and to compare the outcome in patients with or without d...Background: Post-stroke outcomes are poorer in patients with diabetes mellitus (DM). The aim of this study was to determine the prevalence of DM in acute stroke and to compare the outcome in patients with or without diabetes in a tertiary care hospital in Douala, Cameroon. Methods: This was a hospit<span>al</span></span><span style="font-size:10.0pt;font-family:"">-</span><span style="font-size:10.0pt;font-family:"">based prospective cohort study included both diabetic and non-</span><span style="font-size:10.0pt;font-family:"">diabetic acute stroke patients (ASP). Demographic, clinical profile and outcome data was collected within 3 months of stroke onset. Descriptive statistics, t-test and chi square test used for comparisons while associations between DM and stroke outcomes</span><span style="font-size:10.0pt;font-family:"">,</span><span style="font-size:10.0pt;font-family:""> were analyzed using multiple logistic regression and survival analysis. Results: Of the 701 ASP included, the overall prevalence of diabetes in stroke was 34.2% (n = 240) while 9.4% (n = 66) had newly diagnosed diabetes. Mortality was significantly elevated amongst patients with diabetes during hospitalization (p = 0.034) and at 3 months post stroke onset (p = 0.004), but on multivariate analysis, diabetes was not an independent predictor of mortality [OR = 0.984;(95% CI: 0.506 - 1.913);p = 0.961)]. On Cox proportional hazards regression model, the risk of dying was about 1.5 times higher amongst the DM patients compared to non-diabetic patients [adjusted HR (95% CI) of 1.502 (1.128 - 2.000);p = 0.005]. Diabetes w</span><span style="font-size:10.0pt;font-family:"">as</span><span style="font-size:10.0pt;font-family:""> not an independent predictor of poor functional outcome within 3 months post stroke. Conclusion: About 1 in 3 ASP had DM on admission. Survival is better in non-diabetes versus diabetes mellitus ASP. DM was associated with high mortality but does not influence the functional outcome of ASP in our setting</span>展开更多
文摘<div style="text-align:justify;"> <strong>Background:</strong> Data on spontaneous intracerebral haemorrhagic (SICH) are scarce in Africa. Our objectives were<span "=""> to determine the prevalence of SICH, describe the clinical profile, aetiology and evaluate the prognosis (fatality case, functional outcome) of patients in a tertiary health care hospital in Cameroon. <b>Methods:</b> This was a hospital-based retrospective cohort</span><span "=""> </span><span "="">which included patients with SICH and followed up for 6 months after stroke. Subarachnoid haemorrhage, cerebral venous thrombosis with bleeding or bleeding related with ischemic or brain tumour were excluded. Predictive factors were obtained using multiple logistic regression and survival by Kaplan Meier method. <b>Results:</b> The prevalence of SICH was 37% with male predominance (64.0%), a mean age of 55.6 ± 11.8 years. Deep coma was found in 30.3% on admission. The basal ganglion was the most frequent location of haemorrhage (85.1%) while intraventricular blood effusion, mass effect, cerebral oedema and herniation occurred in 31.4%, 25.7%, 8.8% and 5.0% respectively. Hypertension (57.5%) was the most common aetiology. The mean length of hospitalization was 9.0 ± 7.7 days and chest infection (30.7%) was the most frequent complication. The cumulative case fatality rate after 24 hours (day 1), during admission, month 1 and month 3 was 9.6%, 39.9%, 46.0%, 59.8% respectively. On multivariate analysis, GCS < 9 [OR (95% CI) = 3.538 (1.086 - 11.526), p = 0.036] and NIHSS 15 - 24 [OR (95% CI) = 7.498 (1.306 - 43.029), p = 0.024] were independent predictors of in-hospital mortality while mass effect [OR (95% CI) = 3.563 (1.217 - 10.432), p = 0.020] and hyperthermia [OR (95% CI) = 4.645 (1.341 - 16.085), p = 0.015] predict poor functional outcome. Six</span>-<span "="">month survival was 37.8%. <b>Conclusion:</b> About one</span>-<span "="">third of stroke patient were haemorrhagic. Hypertension is the leading CVRF and aetiology of spontaneous ICH. About 1 over 2 patients with SICH would die within 3 months while 50% of survivors would have a poor functional outcome at 6<sup>th</sup> month.</span> </div>
文摘Background: Post-stroke outcomes are poorer in patients with diabetes mellitus (DM). The aim of this study was to determine the prevalence of DM in acute stroke and to compare the outcome in patients with or without diabetes in a tertiary care hospital in Douala, Cameroon. Methods: This was a hospit<span>al</span></span><span style="font-size:10.0pt;font-family:"">-</span><span style="font-size:10.0pt;font-family:"">based prospective cohort study included both diabetic and non-</span><span style="font-size:10.0pt;font-family:"">diabetic acute stroke patients (ASP). Demographic, clinical profile and outcome data was collected within 3 months of stroke onset. Descriptive statistics, t-test and chi square test used for comparisons while associations between DM and stroke outcomes</span><span style="font-size:10.0pt;font-family:"">,</span><span style="font-size:10.0pt;font-family:""> were analyzed using multiple logistic regression and survival analysis. Results: Of the 701 ASP included, the overall prevalence of diabetes in stroke was 34.2% (n = 240) while 9.4% (n = 66) had newly diagnosed diabetes. Mortality was significantly elevated amongst patients with diabetes during hospitalization (p = 0.034) and at 3 months post stroke onset (p = 0.004), but on multivariate analysis, diabetes was not an independent predictor of mortality [OR = 0.984;(95% CI: 0.506 - 1.913);p = 0.961)]. On Cox proportional hazards regression model, the risk of dying was about 1.5 times higher amongst the DM patients compared to non-diabetic patients [adjusted HR (95% CI) of 1.502 (1.128 - 2.000);p = 0.005]. Diabetes w</span><span style="font-size:10.0pt;font-family:"">as</span><span style="font-size:10.0pt;font-family:""> not an independent predictor of poor functional outcome within 3 months post stroke. Conclusion: About 1 in 3 ASP had DM on admission. Survival is better in non-diabetes versus diabetes mellitus ASP. DM was associated with high mortality but does not influence the functional outcome of ASP in our setting</span>
