Acute Stroke at The University College Hospital Ibadan, Nigeria: Clinical Profile and Predictors of 30-day Mortality

Abstract

Stroke is a common public health problem in Nigeria and a leading cause of hospitalization in neurological services. Currently, there is limited information on predictors of early mortality in hospitalized patients in this region. The objectives of this study were to determine the 30-day case fatality rate as well as predictors of early mortality after stroke. This was a prospective study of all stroke patients admitted to the University College Hospital Ibadan Nigeria between July 2002 and September 2003.The diagnosis of stroke was mainly clinical using the WHO clinical criteria. Only 21 patients had Cranial CT scans due to the frequent breakdown of the machine during the study and the high cost of the investigation procedure. Predictors of 30-Day mortality: GCS<8, Hyperglycaemia RBG>140mg/dl, Age>70 years, NIHSS score>20, Heamorrhagic stroke, Systolic and Diastolic Hypertension were studied in all the patients. A total of 135 patients were enrolled in the study, comprising 74 males (54.8%) and 61 women (45.2%). Mean age was 62.3±12.Ischaemic CVD accounted for 71% of all cases while ICH was 22% and SAH was 7%. The over-all mortality was 15.5% and was closely related to the NIHSS score, level of consciousness (GCS) and associated complications such as raised intracranial pressure and aspiration pneumonia. NIHSS score > 20 was the only significant independent predictor of thirty days mortality in this study. The case fatality rate in this study was relatively lower than the value obtained in most previous hospital reports from Nigeria and Africa. This may be due to improved stroke care among others in this centre.

Key words: Stroke, case fatality rate, predictors of 30- day mortality