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ORIGINAL ARTICLE
Year : 2015  |  Volume : 2  |  Issue : 4  |  Page : 165-169

In-hospital stroke mortality and its predictors within one month of ictus: Result from a tertiary hospital in Ilorin, middle belt Nigeria


Department of Medicine, Neurology Unit, University of Ilorin Teaching Hospital, Ilorin, Nigeria

Correspondence Address:
Emmanuel Olatunde Sanya
Department of Medicine, Neurology Unit, University of Ilorin Teaching Hospital, Ilorin
Nigeria
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DOI: 10.4103/2384-5147.172439

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Aims: Identification of predisposing factor(s) for acute stroke death is of utmost importance to clinicians as this will assist in instituting specific therapy and management. This study was set out to determine factor(s) that predict mortality within 30 days of stroke ictus among adult Nigerians. Materials and Methods: A prospective hospital-based study. It involved consecutive adult stroke patients (≥18 years) admitted into the medical wards of the University of Ilorin Teaching Hospital Ilorin, North central Nigeria, between June 2011 and May 2013. Results: The mean age of 302 patients studied was 60.47 ± 13.60 years with more male (53.4%) and no significant difference in mean age between stroke survivors (60.8 ± 13.4 years) and the deceased (59.6 ± 14.0 years). The random blood sugar in survivors and case fatality were 9.4 ± 5.7 mMol/l and 9.3 ± 4.7 mMol/l, respectively. Mean cholesterol level was 6.1 ± 1.3 mMol and 7.1 ± 2.4 mMol in stroke survivors and deceased, respectively. Serum creatinine was higher among case fatality (107.1 ± 49.7 μmol/l) than survivors (101.7 ± 67.2 μmol/l). Brain Computer Tomography was available for 166 (55%) patients with pathologic stroke sub-types of cerebral infarction −71.1%, intracerebral hemorrhage −25.5%, and subarachnoid hemorrhage −3.0%. The median (interquartile range) National Institutes of Health Stroke Scale (NIHSS) score for all was 12 (8-15), survivors 11 (7-14), and 16 (10-23.5) for the deceased (P < 0.01). Sixty-four patients died within the study period giving a case fatality rate of 21.2%. Risk factors for stroke deaths were low Glasgow coma score (<8), high NIHSS score, and presence of complication. The independent predictors of 30 days mortality were admitting stroke severity using NIHSS score (≥15) (P < 0.001) and the presence of at least a complication (P < 0.001). Conclusion: More than one-fifth of these stroke patients died within the first 30 days of the ictus. Prevention, early recognition, and prompt treatment of complications of stroke could help reduce mortality.


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