Predictors of in-hospital mortality among stroke patients in Uyo, Nigeria

Abstract

Background: Stroke is the third leading cause of death in most industrialized countries. Several reports indicate that it is also becoming a major cause of morbidity and mortality in Nigeria and other developing countries.
Aim: To identify risk factors and predictors of in-hospital mortality among patients admitted for stroke in a tertiary health institution in Nigeria.
Methods: Case records of all patients admitted for stroke in the University of Uyo Teaching Hospital from January 2004 to December 2008 were retrieved and relevant data extracted and analysed.  The diagnosis of stroke was made on clinical grounds only.
Results: Three hundred and seven patients with stroke were admitted during the study period. The mean ages were 58.3± 10 years and 58.4± 11.4 years for males and females respectively (p>0.05) indicating that stroke occurred in the sixth decade in both sexes. Systemic hypertension was the commonest risk factor .The overall in- hospital mortality was 24(7.8%) with majority of the mortality [22(7.2%)] occurring within the first seven days of admission. The duration of hospital stay did not influence mortality (p >0.05).Only the female gender and increasing pulse rate were identified as predictors of in hospital mortality (p <0.05).
Conclusion: Most deaths from stroke occur in the first seven days of admission when proper intensive care is critical. The predictors of in-hospital mortality identified in this study add to the previously identified ones and should all be kept in view when managing these patients. The need for the establishment of stroke units especially in our tertiary health institutions is advocated.

Keywords:  Stroke, Predictors, In-hospital mortality, Nigeria