Stroke patients care by the Senegal-National Emergency Medical Services: retrospective study over 18 months

Abstract

ntroduction: Stroke according to the WHO (World Health Organization) is a sudden deficit of focal brain function with no apparent cause other than a vascular cause. It is a major public health problem. It is the first cause of motor disability, second cause of cognitive disability and third cause of mortality in the world. Material and method: It is a retrospective and descriptive study of a period of 18 months (January 1, 2016 to October 30, 2017) conducted in the national Emergency Medical Services of Dakar (Senegal). According to our study criteria, 343 patients were collected. Results: The mean age of the patients was 64.2 years (extremes of 17 and 104 years). Men represented 54.22% (sex ratio M/W 1.8). Dakar represented the main provenance of our patients (79.30%). Hypertension was the main risk factor (50%). Acute headaches were the main warning sign (13.41%). An echocardiography was performed in 59 patients; complete tachyarrhythmia by atrial fibrillation represented 30% of the ECG. The CT-scan was performed for 201 patients (61% of ischemic stroke, 37.5% hemorrhagic and 1.5% of transient ischemic attack). The medevac represented 53.93%. Transportation was made essentially by the emergency medical services; home interventions were the most represented. The mean time for intervention by the emergency medical services was 134.71 minutes. Fann Hospital was the main host structure (45.49%). The care (of the emergency medical services) included, among others, intubation (4.8%), monitoring, oxygen therapy, urinary catheter and medical treatment. We noticed 20.40% of deaths in our series, due essentially to neurological complications. Conclusion: Stroke is a major public health problem. Difficulties are sometimes encountered in the care and the research of an appropriate host structure. The purpose of the pre-hospital care is to intervene as soon as possible while making a clinic diagnosis by performing forthwith a brain CT-scan in order to optimize the care and improve the prognostic of stroke patients.