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Please use this identifier to cite or link to this item: http://hdl.handle.net/123456789/15661

Title: Key determinants of long-term post-stroke mortality in Ghana
Authors: Sarfo, Fred Stephen
Ovbiagele, Bruce
Keywords: Prospective study
Resource-limited region
Resistant hypertension
Stroke mortality
Issue Date: Dec-2021
Publisher: Journal of the Neurological Sciences 434 (2022) 120123
Citation: Journal of the Neurological Sciences 434 (2022) 120123
Abstract: Background: Stroke affects a predominantly young to middle-aged population in Africa and is associated with poor outcomes. There are limited data on patient-level determinants of long-term stroke survival on the continent. Purpose: To assess factors associated with long-term, all-cause mortality among stroke survivors in a Ghanaian medical system. Methods: We analyzed the dataset of clinical trial involving hypertensive stroke survivors (n = 60) who enrolled in a 9-month study primarily assessing the effect of an m-health intervention on blood pressure control. This was a single tertiary center study conducted in a Ghanaian medical center. Participants or relatives were contacted by a phone call to assess vital status 4.5 years after stroke onset. Demographic, psycho-social and vascular risk factors data were collected during the study. Cox proportional hazards regression modeling was used to assess the factors associated with death. Results: Among the study participants, long term information was obtainable on 58 of 60 (97%). After a median follow-up of 52 months [IQR: 48 to 53 months], 16 participants had died, resulting in a mortality rate of 27.6% (95% CI of 16.6% - 40.9%). Upon adjustment for confounders, the two factors independently associated with long-term mortality were resistant hypertension (Hazard Ratio 3.99; 95% CI: 1.29–12.37] and depression (Hazard Ratio 1.18; 95% CI: 1.05–1.31; per unit rise on the Hamilton Depression Scale). Conclusion: In this convenience sample of recent stroke patients in Ghana, over a quarter had died within 5 years of index stroke onset. Resistant hypertension and depression may be modifiable therapeutic targets to improve outcomes in these patients.
Description: This article is published by Journal of the Neurological Sciences and is also available at https://doi.org/10.1016/j.jns.2021.120123
URI: 10.1016/j.jns.2021.120123
Appears in Collections:College of Health Sciences

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