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|Title: ||Trends in stroke admission and mortality rates from 1983 to 2013 in central Ghana|
|Authors: ||Sarfo, Fred Stephen|
|Issue Date: ||2015|
|Publisher: ||Journal of the Neurological Sciences|
|Citation: ||Journal of the Neurological Sciences, 357 (2015) 240–245|
|Abstract: ||Background: Accumulating data based on model-derived estimates suggest rising rates of stroke in sub-Saharan
Africa over the next several decades. Stroke is a leading cause of death, disability, and dementia worldwide.
Directly enumerated hospital-based data on the longitudinal trajectory of stroke admissions and deaths in sub-
Saharan Africa could help hospital administrators, public health officials, and government policy-makers with
planning and utilization of scarce resources.
Objective: To evaluate 30-year trends in stroke admission and mortality rates in central Ghana.
Methods: We undertook a retrospective analysis of data on stroke admissions and mortality at a tertiary referral
hospital in central Ghana between 1983 and 2013. Rates of stroke admissions and mortality were expressed as
stroke admissions or deaths divided by total number of hospital admissions or deaths respectively. Yearly crude
case fatality fromstroke was calculated and predictors of stroke mortality were determined using Cox proportional
hazards regression analysis.
Results: Over the period, there were 12,233 stroke admissions with equal gender distribution. The rate of stroke
admissions increased progressively from 5.32/1000 admissions in 1983 to 13.85/1000 admissions in 2010 corresponding
to a 260% rise over the period. Stroke mortality rates also increased from 3.40/1000 deaths to 6.66/1000
deaths over the 30-year period. The average 28-day mortality over the period was 41.1%. Predictors of in-patient
mortality were increasing age-aHR of 1.31 (1.16–1.47) for age N 80 years comparedwith b40 years and admissions
in 2000's comparedwith 1980's; aHR of 1.32 (1.26–1.39). Of the 1132 stroke patients with neuroimaging data: 569
(50.3%) had intracerebral hemorrhage, 382 (33.7%) had ischemic stroke and 181 (16.0) had sub-arachnoid hemorrhage.
Patients with ischemic stroke were significantly older than those with ICH and SAH respectively.
Conclusion: Rates of stroke admission and mortality have increased steadily over the past three decades in central
Ghana. More intensive risk modification and optimization of acute stroke care are urgently needed to stem these
|Description: ||An article published in Journal of the Neurological Sciences, 357 (2015) 240–245|
|Appears in Collections:||College of Health Sciences|
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