Neurologic emergencies and related deaths: A call for stroke management in organized stroke units in tropical hospitals.

Abstract

Background:
Neurologic emergencies are common and often times the outcome is unfavorable. This was a study of the frequency of neurologic emergencies and related deaths in the medical emergency department of a tropical tertiary healthcare center aimed at highlighting the lingering high frequency of neurologic emergencies and related deaths with a view to make suggestions on how to improve outcome.
Methods:
This was a two-year retrospective review of neurologic emergencies and related deaths at the medical emergency department of a Nigerian tertiary hospital.
Results:
A total of 1302 medical emergency patients comprising 688 (52.8%) males and 614 (47.2%) females were studied. Neurologic diseases were the most frequent medical emergencies, accounting for 21.4% (n=278) of cases. Stroke was the most frequent neurologic emergency accounting for 64.7% (n=180/278) of neurologic emergencies. There were a total of 214 medical emergency deaths of which neurologic diseases accounted for 35.04% (n=75/214). Stroke was also the most frequent cause of all medical emergency deaths accounting for 25.2% (n=54/214) of all medical emergency deaths and 71.1% (n=54/75) of deaths due to neurologic diseases.
Conclusions:
Neurologic emergencies and its related deaths are high especially death from stroke and this requires urgent attention. Introduction of stroke units has been shown to improve stroke management outcome where they exist, but such units are largely lacking in most tertiary centers in the tropics. It is time for the establishment of such units in these centers given the high number of deaths due to stroke as seen in this study.