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Long-Term Mortality of Stroke Survivors in Parakou: 5-Year Follow-Up

2020; Elsevier BV; Volume: 29; Issue: 6 Linguagem: Inglês

10.1016/j.jstrokecerebrovasdis.2020.104785

1532-8511

Thierry Adoukonou, Mendinatou Agbétou, Roland Bangbotché, Oyéné Kossi, Pervenche Fotso Mefo, Julien Magné, Dismand Stéphan Houinato, Pierre‐Marie Preux, Philippe Lacroix,

Healthcare Systems and Practices

The burden of stroke is high in Africa, but few data are available on the long-term outcome of strokes in this area.We aimed to study the long-term outcome of stroke survivors in Parakou from 2012 to 2018.It was a cohort study and included 247 stroke patients admitted to the University Hospital of Parakou from January 1, 2012 to April 30, 2018. Each patient was followed up for at least 1 year. The modified RANKIN scale was used to evaluate patients. Verbal autopsy was used to ascertain the cause of death. The survival probability was estimated using the Kaplan-Meier method. Predictors of mortality were estimated using the Cox proportional model and the hazard ratio (HR) and their 95% confidence intervals were determined. The data were analyzed using Stata Software.The mean age was 58.1 ± 13.4 years with a sex ratio of 1.12. Among stroke survivors, the mortality was 10.1% at 3 months, 11.7% at 6 months, 15.4% at 1 year, 21.5% at 3 years, and 23.5% at 5 years. The probability of survival after a stroke was 66.5% at 5 years. Factors associated with mortality were age with adjusted HR 1.4 (1.2-1.7) for each 10 years, male sex with aHR 2.3 (1.2-4.6), history of hypertension with aHR 2.0 (1.0-4.1) and the severity of the initial neurological impairment National Institute of Health Stroke Scale with aHR 1.1 (1.0-1.2) for each 1 point. The main causes of death were recurrent stroke, infectious diseases, and cardiac disease. The proportion of patients with functional disability was 53.8% at 1 year. The quality of life was generally impaired in terms of physical health, personal environment, and finances.The long-term prognosis of stroke patients in Parakou is poor. It requires urgent action to reduce this burden.