Introduction: Stroke is the leading cause of mortality and physical disability in sub-Saharan Africa. Objective: Determining medium-term and long-term mortality for stroke and identifying associated factors. Method: I...Introduction: Stroke is the leading cause of mortality and physical disability in sub-Saharan Africa. Objective: Determining medium-term and long-term mortality for stroke and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved patients who have known stroke for at least 6 months, and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Then, the number of deceased was systematically recorded with precision of death time-limit. Results: The overall mortality rate was 29%. Mortality was higher with patients over 70 years with a frequency of 57.1%. The medium-term mortality rate was 25% against 4% for long-term. The average time-limit for death occurrence after the vascular incident was 7 months ± 6.4 months. Prognostic factors of mortality were: the age of the patient (IC95% = 7.73 [1.49 - 39.99], p = 0.015 ), marital status (IC95% = 0.27 [0.08 to 0.94], p = 0.039 ) and the presence of aphasia (IC95% = 5.52 [1.45 to 20.94 ], p = 0.012). Conclusion: Stroke mortality still remains significant, even after the patients have been discharged from hospital. A good psychological family support and efficient aphasia coverage are essential for its reduction.展开更多
Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occu...Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79-73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs.展开更多
文摘Introduction: Stroke is the leading cause of mortality and physical disability in sub-Saharan Africa. Objective: Determining medium-term and long-term mortality for stroke and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study that was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. It involved patients who have known stroke for at least 6 months, and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. Then, the number of deceased was systematically recorded with precision of death time-limit. Results: The overall mortality rate was 29%. Mortality was higher with patients over 70 years with a frequency of 57.1%. The medium-term mortality rate was 25% against 4% for long-term. The average time-limit for death occurrence after the vascular incident was 7 months ± 6.4 months. Prognostic factors of mortality were: the age of the patient (IC95% = 7.73 [1.49 - 39.99], p = 0.015 ), marital status (IC95% = 0.27 [0.08 to 0.94], p = 0.039 ) and the presence of aphasia (IC95% = 5.52 [1.45 to 20.94 ], p = 0.012). Conclusion: Stroke mortality still remains significant, even after the patients have been discharged from hospital. A good psychological family support and efficient aphasia coverage are essential for its reduction.
文摘Introduction: Cognitive disorders frequency arising after a cardio-cerebral vascular disease (stroke) is currently on the rise due to the ageing population and the increase in the number of survivors after stroke occurrence. Objective: Determining post-stroke cognitive decline and identifying associated factors. Method: It consists in a cross-sectional, prospective, descriptive and analytical study which was conducted from April 1 to August 31, 2013 in the Neurology Department of CNHU-HKM in Cotonou. The study involved 100 patients who have known stroke for at least the past 6 months and were all admitted and discharged later on. The disease survivors were re-contacted and examined again at home or at hospital. The cognitive decline (CD) was estimated by using a modified and adapted MMSE to suit our cultural era. Results: All patients were aged 58.9 years ± 13.6 years. Sex-ratio was 1.4. Cognitive decline frequency was 20%. Post-stroke cognitive decline frequency per sex was 11.6% and 8.4% respectively for females and males. Ischemia stroke patients had a higher cognitive decline (22.5%). 58.3% had severe CD. Moreover the CD frequency increased with time, from 16.7% in a year to 50% in 3 years. Total MMSE varied from 6 to 23 with 21 as median. From the unvaried analysis, the presence of sphincter disorders (1.26 [0.35-4.59], p = 0.004), consciousness disorders (15.67 [1.46-168], p = 0.04), and convulsion disorders (3.77 [1.01 -14.00], p = 0.003) was associated with cognitive decline. From multi-varied analysis, the sole presence of convulsive attacks (11.5 [1.79-73.58], p = 0.01) was individually associated with post-stroke cognitive decline. Conclusion: This study reveals the importance of CD after stroke. The occurrence of convulsions at stroke acute stage is a prognostic factor of CD medium or long-term occurrence. The overall coverage improvement depends on the integration of these data in stroke reach-out programs.
