Types, risk profiles, and outcomes of stroke patients in a tertiary teaching hospital in northern Ethiopia

•Low ischemic to hemorrhagic stroke ratio compared with developed countries•Hypertension and other stroke risk factors were under-identified and under-treated.•Less than 10% of patients reached the hospital within 3 h of stroke symptoms.•Financial and social barriers to accessing CT Scan affected quality of stroke care.

BackgroundStroke is becoming an increasingly serious public health issue in Ethiopia and the paucity of data specific to the Ethiopian setting is limiting the formulation of an appropriate response.ObjectiveThis study aimed to describe types, risk factors, management patterns, and outcomes among stroke patients treated at a tertiary teaching hospital in northern Ethiopia from 2012 to 2014.DesignMedical record review with a standardized abstraction tool was used to obtain all data for this retrospective case study. Data was entered in EpiInfo Version 7 and analyzed using STATA12. Descriptive statistics were used to explore differences among stroke subtypes and compare with other sub-Saharan African countries.ResultsAmong 142 stroke patients (mean age 62.8 ± 15.6 years, 54.2% male), ischemic stroke was the most frequent subtype (55.6%) followed by intracerebral hemorrhage (32.4%) and subarachnoid hemorrhage (5.6%). 38.0% of patients had pre-existing hypertension and 4.9% had pre-existing diabetes, and most were not on any treatment. 66.2% of patients were hypertensive at hospital arrival and nearly all presented with focal neurological deficit. Less than 10% arrived at the hospital within 3 h of stroke; nearly half (47.9%) were delayed over 24 h. 76.1% received CT Scan. We observed 12.0% in-hospital mortality.ConclusionsIschemic stroke was the predominant form of stroke, although to a lesser degree than in studies from developed countries. Under-diagnosing of hypertension and other risk factors and delayed presentation at the hospital are the major challenges to address.