Abstract
Background Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). Methods A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome. Results Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03) were independent predictors of poor treatment outcomes. Conclusion Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).
Highlights
Stroke is a public health problem in Ethiopia
World Health Organization (WHO) has estimated that about 15 million new stroke cases per year were diagnosed around the globe; two thirds of them were occurred in lowand middle-income countries (LMIC)
Unlike the previous studies conducted in Ethiopia [11, 29], the finding of the present study showed that higher percentage (63.18%) of the patients had poor treatment outcomes, of which 18.18% of patients died in the hospital while 45.00% of the patients were discharged with physical disabilities
Summary
Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. This study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC). Stroke is among the most disabling cerebrovascular disease that result in significant amount of residual deficit leading to economic loss. This high burden of poor outcomes of stroke is attributable to its high in-hospital mortality. The Global Burden of Diseases (GBD) study showed about 80% stroke-related death that occur in LMIC indicating that developing countries carry the heavy burden of stroke-related disability, mortality, and morbidity [6, 7]. Study conducted in Shashemene, Ethiopia, showed that about 45% of the patients with stroke had poor treatment outcomes [11]
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