Abstract
Background
About
three quarters of stroke deaths occur in developing countries including
those in sub-Saharan African. Short and long-term stroke fatality data
are needed for health service and policy formulation.
Methods
We
prospectively followed up from stroke onset, 254 patients recruited
from the largest reference hospitals in Yaounde (Cameroon). Mortality
and determinants were investigated using the accelerated failure time
regression analysis.
Results
Stroke
mortality rates at one-, six- and 12 months were respectively 23.2%
(Ischemic strokes: 20.4%, hemorrhagic strokes: 26.1%, and undetermined
strokes: 34.8, p = 0.219), 31.5% (ischemic strokes: 31.5%, hemorrhagic
strokes: 30.4%, and undetermined strokes: 34.8%, p = 0.927), and 32.7%
(ischemic strokes: 32.1%, hemorrhagic strokes: 30.4%, undetermined
strokes: 43.5%, p = 0.496). Fever, swallowing difficulties, and
admission NIHSS independently predicted mortality at one month, six and
12 months. Elevated systolic blood pressure (BP) predicted mortality at
one month. Elevated diastolic blood pressure was a predictor of
mortality at one month in participants with hemorrhagic stroke. Low
hemoglobin level on admission only predicted long term mortality.
Conclusion
In
this resource-limited setting, post-stroke mortality was high with 1
out of 5 deaths occurring at one month and up to 30% deaths at six and
twelve months after the index event. Fever, stroke severity, elevated BP
and anemia increased the risk of death. Our findings add to the body of
evidence for the poor outcome after stroke in resource limited
environments.
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