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Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia

BACKGROUND: Stroke is one of the top causes of functional disability around the world. The main objective was to identify stroke-related functional outcomes and risk factors. A good functional outcome is defined as the absence of problems secondary to the stroke event, a poor functional outcome as t...

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Autores principales: Tento, Tegenu, Kume, Abraham, Kumaso, Sebisibe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617073/
https://www.ncbi.nlm.nih.gov/pubmed/37907867
http://dx.doi.org/10.1186/s12883-023-03444-8
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author Tento, Tegenu
Kume, Abraham
Kumaso, Sebisibe
author_facet Tento, Tegenu
Kume, Abraham
Kumaso, Sebisibe
author_sort Tento, Tegenu
collection PubMed
description BACKGROUND: Stroke is one of the top causes of functional disability around the world. The main objective was to identify stroke-related functional outcomes and risk factors. A good functional outcome is defined as the absence of problems secondary to the stroke event, a poor functional outcome as the presence of complications, and mortality as the existence of complications. METHOD: A retrospective cohort analysis was used to observe factors in 298 eligible adult (18 or older) stroke patients who attend outpatient clinics every three months at Felege Hiwot Referral Hospital between September 2019 and August 2021 to predict outcomes. RESULT: The likelihood of dying from a poor outcome was 9%, and the likelihood of recovering was 24%. The average time spent on good and poor outcomes for different levels of independent variables varies according to their risk. During the first three years of follow-up, the instantaneous risk with a 95% confidence interval of transitioning from good to poor outcome in the women, aged 60 or older, with hypertension, atrial fibrillation, and hemorrhage stroke versus men stroke patients, aged 18 to 59, without hypertension, atrial fibrillation, and ischemic stroke were 1.54 (1.10, 2.15), 1.73 (1.19, 2.52), 2.34 (1.55, 3.53), 2.74 (1.64, 4.56), and 1.52 (1.10, 2.19) respectively. The hazard ratio of transitioning from poor outcome to death for patients with diabetes mellitus and atrial fibrillation versus those without diabetes mellitus and atrial fibrillation was estimated to be 1.95 (1.10, 3.46) and 3.39 (1.67, 6.89), respectively. CONCLUSION: Women over 60 with hypertension, atrial fibrillation, and hemorrhagic stroke were more likely to progress from a good to a poor outcome. Diabetes and atrial fibrillation were also risk factors for progressing from a poor outcome to death. The states and transitions, as well as a clinical control of the hazards for the transition through states, should improve the physician’s decision-making process. Since gender and age are difficult to control, early intervention by patients and the hospital may be critical in influencing functional outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-023-03444-8.
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spelling pubmed-106170732023-11-01 Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia Tento, Tegenu Kume, Abraham Kumaso, Sebisibe BMC Neurol Research BACKGROUND: Stroke is one of the top causes of functional disability around the world. The main objective was to identify stroke-related functional outcomes and risk factors. A good functional outcome is defined as the absence of problems secondary to the stroke event, a poor functional outcome as the presence of complications, and mortality as the existence of complications. METHOD: A retrospective cohort analysis was used to observe factors in 298 eligible adult (18 or older) stroke patients who attend outpatient clinics every three months at Felege Hiwot Referral Hospital between September 2019 and August 2021 to predict outcomes. RESULT: The likelihood of dying from a poor outcome was 9%, and the likelihood of recovering was 24%. The average time spent on good and poor outcomes for different levels of independent variables varies according to their risk. During the first three years of follow-up, the instantaneous risk with a 95% confidence interval of transitioning from good to poor outcome in the women, aged 60 or older, with hypertension, atrial fibrillation, and hemorrhage stroke versus men stroke patients, aged 18 to 59, without hypertension, atrial fibrillation, and ischemic stroke were 1.54 (1.10, 2.15), 1.73 (1.19, 2.52), 2.34 (1.55, 3.53), 2.74 (1.64, 4.56), and 1.52 (1.10, 2.19) respectively. The hazard ratio of transitioning from poor outcome to death for patients with diabetes mellitus and atrial fibrillation versus those without diabetes mellitus and atrial fibrillation was estimated to be 1.95 (1.10, 3.46) and 3.39 (1.67, 6.89), respectively. CONCLUSION: Women over 60 with hypertension, atrial fibrillation, and hemorrhagic stroke were more likely to progress from a good to a poor outcome. Diabetes and atrial fibrillation were also risk factors for progressing from a poor outcome to death. The states and transitions, as well as a clinical control of the hazards for the transition through states, should improve the physician’s decision-making process. Since gender and age are difficult to control, early intervention by patients and the hospital may be critical in influencing functional outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12883-023-03444-8. BioMed Central 2023-10-31 /pmc/articles/PMC10617073/ /pubmed/37907867 http://dx.doi.org/10.1186/s12883-023-03444-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Tento, Tegenu
Kume, Abraham
Kumaso, Sebisibe
Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia
title Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia
title_full Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia
title_fullStr Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia
title_full_unstemmed Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia
title_short Risk factors for stroke-related functional disability and mortality at Felege Hiwot Referral Hospital, Ethiopia
title_sort risk factors for stroke-related functional disability and mortality at felege hiwot referral hospital, ethiopia
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10617073/
https://www.ncbi.nlm.nih.gov/pubmed/37907867
http://dx.doi.org/10.1186/s12883-023-03444-8
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