Magnitude and predictors of stroke treatment outcomes in low resource settings: A cross-sectional study

Abstract

Background: Stroke is one of the most common causes of morbidity and mortality worldwide. The global burden of disease study indicates that 87% of stroke deaths occur in low- and middle-income regions. Currently, stroke has become an important public health problem in Ethiopia. According to the latest World Health Organization (WHO) data published in May 2018, stroke deaths in Ethiopia reached 32,859 or 5.38% of total deaths. It is the fourth leading cause of death. So the current study was aimed to assess stroke treatment outcomes and their associated factors. Method: A cross-sectional study design was conducted on stroke patients who had been hospitalized in the last two years (April 1, 2020, to March 31, 2022) using a simple random technique. The stroke treatment outcome was the outcome variable. The collected data was entered and analyzed using Statistical Package for the Social Sciences (SPSS) version 23. Descriptive statistics and logistic regression were done, and P-values less than 0.05 were considered statistically significant with 95% confidence intervals (CI). Result: Of the total 135 hospitalized stroke patients at Mettu Karl Comprehensive Specialized Hospital (MKCSH) and Bedele General Hospital (BGH), the majority 85 (63%) of them were males. About two-thirds of the stroke patients had ischemic strokes 87(64.4%). Regarding their treatment outcomes, nearly two thirds 85(63%) of the patients had poor treatment outcomes. The most commonly prescribed drugs for stroke treatment were Aspirin [ASA] plus Atorvastatin that accounts 50(37%). Age ≥ 65 (AOR: 0.13; 95% CI: 0.027–0.64, P = 0.012), lack of formal education (AOR: 6.5; 95% CI: 1.09–38.81, P = 0.04), chewing a khat (AOR: 2.67; 95% CI: 1.03–6.9, P = 0.043), Glasgow coma scale 8 (AOR: 4.33; 95% CI: 1.68–11.32, P = 0.002), and admission to hospital after 24 h of stroke symptom(AOR: 17.7; 95% CI: 3.78–83.5, P < 0.001) were a predictors of stroke treatment outcomes. Conclusion: Nearly two thirds of the patients had poor treatment outcomes, and ischemic stroke was found to be the most commonly diagnosed stroke types at Mettu Karl Comprehensive Specialized Hospital (MKCSH) and Bedele General Hospital (BGH). Along with other socio-demographic factors, delayed admission (after 24 h of symptom onset), low Glasgow coma scale and being a khat chewer were strongly associated with poor treatment outcome. Therefore, health education about the effects of khat chewing and the symptoms of strokes should be given to stroke patients in order to prevent the risk of a delayed admission.

Keywords

• Treatment outcome
• Stroke
• Contributing factors
• Ethiopia