کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3049554 1579804 2016 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Computed tomography scanning and stroke mortality in an urban medical unit in Cameroon
ترجمه فارسی عنوان
اسکن توموگرافی کامپیوتری و مرگ و میر سکته مغزی در یک واحد پزشکی شهری در کامرون
کلمات کلیدی
موضوعات مرتبط
علوم زیستی و بیوفناوری علم عصب شناسی سیستم های درون ریز و اتونومیک
چکیده انگلیسی


• One out of 5 patients with stroke will die during initial hospitalization.
• Not receiving a brain-imaging diagnosis was associated with high death rates, consistently across baseline characteristics.
• The excess mortality was at least in part explained by the severity of the disease and the late admission.

BackgroundDespite the increasing availability of head computerized tomography (CT) in resource-limited settings, it is unclear if brain-imaging-based diagnosis of stroke affects the outcomes in the absence of dedicated structures for acute stroke management.ObjectivesIn a major referral hospital in the capital city of Cameroon, we compared in-hospital mortality rates in patients with a WHO-based diagnosis of stroke between participants with and without brain imaging on admission.MethodsStroke patients with and without admission brain imaging were compared for demographic characteristics, risk factors, clinical and laboratory characteristic, and in-hospital mortality. Heterogeneities in mortality rates (CT vs. No CT) across major subgroups were investigated via interaction tests, and logistic regressions used to adjust for extraneous factors such as age, sex, year of study, residency, history of diabetes and hypertension, history of stroke, Glasgow coma scale, and delay between stroke symptoms onset and hospital admission.ResultsOf the 1688 participants included in the final analysis, 1048 (62.1%) had brain imaging. The median age of the non-CT vs. CT groups was 65 vs. 62 years (p-value < 0.0001%). The death rate of non-CT vs. CT groups was 27.5% vs. 16.4% (p < 0.0001). This difference was mostly similar across major subgroups, and robust to the adjustments for confounders (in spite of substantial attenuation), with excess deaths in those with CT ranging from 65% to 149%.ConclusionIn this resource-limited environment, the absence of brain imaging on admission was associated with high in-hospital death from stroke, which was only partially explained by delayed hospitalization with severe disease. These results stressed the importance of scaling up acute stroke management in low- and middle-income countries.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: eNeurologicalSci - Volume 2, March 2016, Pages 3–7
نویسندگان
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