Three months outcome of a sample of stroke patients in Erbil city

Namir Ghanim Al-Tawil
Department of Community Medicine, College of Medicine, Hawler Medical University, Erbil, Iraq.
Abdullah Faqiyazdin Mzury
Department of Neurology, Kurdistan Board for Medical Specialties, Erbil, Iraq.
Azad Hasan Kheder
Department of Physiotherapy, Erbil Technical Health and Medical College, Erbil Polytechnic University, Erbil, Iraq.
Hassan Ali Tahir Al–Sulaivany
Rizgary Teaching Hospital, Erbil, Iraq.
Share:

Abstract

Background and objective: Stroke is still one of the major causes of death, and the incidence and mortalities are increasing. The objective of the study is to measure the three months outcome of stroke patients discharged alive from the hospital.

Methods: A longitudinal study was carried out in Rizgary Teaching Hospital in Erbil, Iraq during the period from 1st of April, 2018 to the 30th September, 2018 involving 100 patients with ischemic stroke.

Results: The mean age (± SD) of patients was 64.15 ± 13.35 years, the age ranging from 26-89 years, and the median was 65 years. More than half (54%) of patients were males. Twenty (20%) patients died within three months after the development of stroke, 4% developed ischemic stroke after three months. Significantly higher rates of death were detected among those with chronic obstructive pulmonary disease (P <0.001) and those with dysphagia (P = 0.002). No significant association was detected between the case fatality rate with age, gender, body mass index, smoking, hypercholesterolemia, ischemic heart disease, angina, congestive heart failure, atrial fibrillation, heart valve dysfunction, strenuous physical activity, treatment for diabetes, treatment for high cholesterol, and HbA1c levels.

Conclusion: The case fatality rate was relatively high three months after the development of stroke. It is recommended to strengthen the follow up measures after patients’ discharge from the hospital.

Metrics

Metrics Loading ...

References

  1. Feigin VL, Forouzanfar MH, Krishnamurthi R, Mensah GA, Connor M, Bennett DA, et al. Global and regional burden of stroke during 1990–2010: findings from the Global Burden of Disease Study 2010. Lancet. 2014; 383(9913):245–55. https://doi.org/10.1016/s0140-6736(13)61953-4
  2. Béjot Y, Bailly H, Durier J, Giroud M. Epidemiology of stroke in Europe and trends for the 21st century. Med Press. 2016; 45(12):391–8. https://doi.org/10.1016/j.lpm.2016.10.003
  3. Lecoffre C, de Peretti C, Gabet A, Grimaud O, Woimant F, Giroud M, et al. National trends in patients hospitalized for stroke and stroke mortality in France, 2008 to 2014. Stroke. 2017; 48(11):2939–45. https://doi.org/10.1161/STROKEAHA.117.017640
  4. Grube MM, Koennecke HC, Walter G, Meisel A, Sobesky J, Nolte CH, et al. Berlin Stroke Register (BSR). Influence of acute complications on outcome 3 months after ischemic stroke. PloS One. 2013; 8(9):75719. https://doi.org/10.1371/journal.pone.0075719
  5. Bernhardt J, Hayward KS, Kwakkel G, Ward NS, Wolf SL, Borschmann K, et al. Agreed definitions and a shared vision for new standards in stroke recovery research: the stroke recovery and rehabilitation roundtable taskforce. Int J Stroke. 2017; 12(5):444–50. https://doi.org/10.1177/1747493017711816
  6. Grefkes C, Fink GR. Recovery from stroke: current concepts and future perspectives. Neurol Res Pract. 2020; 2(1):1–0. https://doi.org/10.1186/s42466-020-00060-6
  7. Stinear CM. Prediction of motor recovery after stroke: advances in biomarkers. Lancet Neurol. 2017; 16(10):826–36. https://doi.org/10.1016/S1474-4422(17)30283-1.
  8. Winters C, van Wegen EE, Daffertshofer A, Kwakkel G. Generalizability of the proportional recovery model for the upper extremity after an ischemic stroke. Neurorehabil Neural Repair. 2015; 29(7):614–22. https://doi.org/10.1177/1545968314562115
  9. Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, Harry V. AHA/ASA Expert Consensus Document An updated definition of stroke for the 21st century a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013; 44(7):2064–89.
  10. Saver JL, Filip B, Hamilton S, Yanes A, Craig S, Cho M, et al. Improving the reliability of stroke disability grading in clinical trials and clinical practice: the Rankin Focused Assessment (RFA). Stroke. 2010; 41(5):992–5. https://doi.org/10.1161/STROKEAHA.109.571364
  11. Idrovo L, Fuentes B, Medina J, Gabaldón L, Ruiz-Ares G, Abenza MJ, et al. Validation of the FOUR Score (Spanish Version) in acute stroke: an interobserver variability study. Eur Neurol. 2010; 63(6):364–9. https://doi.org/10.1159/000292498
  12. Essa A, Helmy TA, El Batch S. Study of incidence, risk factors and outcome of acute cerebrovascular stroke patients admitted to Alexandria Main University Hospital. J Am Sci. 2011; 7(11):316–29.
  13. Bushnell CD, Chaturvedi S, Gage KR, Herson PS, Hurn PD, Jiménez MC, et al. Sex differences in stroke: challenges and opportunities. J Cereb Blood Flow Metab. 2018; 38(12):2179–91. https://doi.org/10.1177/0271678X18793324
  14. Hiraga A. Gender differences and stroke outcomes. Neuroepidemiology 2017; 48(1-2):61–2. https://doi.org/10.1159/000475451
  15. Grube MM, Koennecke HC, Walter G, Meisel A, Sobesky J, Nolte CH, et al. Berlin Stroke Register (BSR). Influence of acute complications on outcome 3 months after ischemic stroke. PloS One 2013; 8(9):75719. https://doi.org/10.1371/journal.pone.0075719
  16. Rodriguez-Castro E, Lopez-Dequit I, Santamaria-Cadavid M, Arias-Rivas S, Rodriguez-Yanez M, Pumar JM, et al. Trends in stroke outcomes in the last ten years in a European tertiary hospital. BMC Neurol. 2018; 18(1):1–10. https://doi.org/10.1186/s12883-018-1164-7
  17. Yusuf S. Two decades of progress in preventing vascular disease. Lancet. 2002; 360(9326):2–3. https://doi.org/10.1016/S0140-6736(02)09358-3
  18. Ismail KH. The outcome of stroke: A six month follow-up study. Zanco J Med Sci. 2018; 22(1):82–8. https://doi.org/10.15218/zjms.2018.011
  19. Arsava EM, Kim GM, Oliveira-Filho J, Gungor L, Noh HJ, de Jesus Lordelo M, et al. Prediction of early recurrence after acute ischemic stroke. JAMA Neurol. 2016; 73(4):396–401. https://doi.org/10.1001/jamaneurol.2015.4949
  20. Wang Y, Xu J, Zhao X, Wang D, Wang C, Liu L, et al. Association of hypertension with stroke recurrence depends on ischemic stroke subtype. Stroke. 2013; 44(5):1232–7. https://doi.org/10.1161/STROKEAHA.111.000302
  21. Sönmezler A, Keşkek SO. Dysphagia in Patients with Acute Ischemic Stroke in a Tertiary Care Hospital. J Intensive Crit Care. 2019; 5(1):8. https://doi.org/10.21767/2471-8505.100127
  22. Khedr EM, Abbass MA, Soliman RK, Zaki AF, Gamea A. Post-stroke dysphagia: frequency, risk factors, and topographic representation: hospital-based study. Egypt J Neurol Psychiatr Neurosurg. 2021; 57(1):1–8. https://doi.org/10.1186/s41983-021-00281-9
  23. Crary MA, Humphrey JL, Carnaby-Mann G, Sambandam R, Miller L, Silliman S. Dysphagia, nutrition, and hydration in ischemic stroke patients at admission and discharge from acute care. Dysphagia. 2013; 28:69–76. https://doi.org/10.1007/s00455-012-9414-0
  24. Arnold M, Liesirova K, Broeg-Morvay A, Meisterernst J, Schlager M, Mono ML, et al. Dysphagia in acute stroke: incidence, burden and impact on clinical outcome. PloS One. 2016 10; 11(2):e0148424. https://doi.org/10.1371/journal.pone.0075719
  25. Nguyen VQ, PrvuBettger J, Guerrier T, Hirsch MA, Thomas JG, Pugh TM, et al. Factors associated with discharge to home versus discharge to institutional care after inpatient stroke rehabilitation. Arch Phys Med Rehabil. 2015; 96(7):1297–303. https://doi.org/10.1016/j.apmr.2015.03.007
  26. Lekoubou A, Ovbiagele B. Prevalence and influence of chronic obstructive pulmonary disease on stroke outcomes in hospitalized stroke patients. E Neurological Sci. 2017; 6:21–4. https://doi.org/10.1016/j.ensci.2016.11.007
  27. Cunningham TJ, Ford ES, Rolle IV, Wheaton AG, Croft JB. Associations of self-reported cigarette smoking with chronic obstructive pulmonary disease and co-morbid chronic conditions in the United States. COPD: Chronic Obstr Pulm Dis. 2015; 12(3):281–91. https://doi.org/10.3109/15412555.2014.949001
  28. ElHabr AK, Katz JM, Wang J, Bastani M, Martinez G, Gribko M, et al. Predicting 90-day modified Rankin Scale score with discharge information in acute ischaemic stroke patients following treatment. BMJ Neurol Open. 2021; 3:e000177. https://doi.org/10.1136/bmjno-2021-000177
  29. Qureshi AI, Chaudhry SA, Sapkota BL, Rodriguez GJ, Suri MF. Discharge destination as a surrogate for Modified Rankin Scale defined outcomes at 3-and 12-months poststroke among stroke survivors. Arch Rehabil Res Clin Transl. 2012; 93(8):1408–13. https://doi.org/10.1016/j.apmr.2012.02.032
  30. Luitse MJ, Velthuis BK, Kappelle LJ, van der Graaf Y, Biessels GJ, DUST Study Group. Chronic hyperglycemia is related to poor functional outcome after acute ischemic stroke. Int. J Stroke. 2017; 12(2):180–6. https://doi.org/10.1177/1747493016676619
How to Cite
Al-Tawil, N. G. ., Mzury, A. F., Kheder, A. H. ., & Al–Sulaivany, H. A. T. . (2022). Three months outcome of a sample of stroke patients in Erbil city. Zanco Journal of Medical Sciences (Zanco J Med Sci), 26(3), 270–276. https://doi.org/10.15218/zjms.2022.029

Send mail to Author


Send Cancel