Stroke Subtypes, Risk Factors and Treatment Outcomes at A Tertiary Hospital Situated in Rural Southwestern Nigeria: A Five- Year Restrospective Observational Study

Abstract

Introduction: Despite the high burden of stroke globally, there is an observed paucity of data regarding its subtypes, risk factors and treatment outcomes in rural Southwestern Nigeria. The study ascertained the subtypes, risk factors and treatment outcomes of stroke at the adult Accident and Emergency Department of a tertiary hospital in a rural Southwestern Nigeria. Materials and methods: A retrospective survey using data form and standardized questionnaire was used to review the patients admitted for stroke between January 2015 and December 2019. The data were analyzed using SPSS Version 22.0. The results were presented in descriptive and tabular formats. Results: In this study, 276 stroke patients comprised Ischemic (60.1%) vs Hemorrhagic (39.9%) strokes were studied. The mean age of the patients was 67.3±11.1 years. The majority were males and were older than 65 years. The independent predictors of stroke admissions were Informal education [(AOR = 0.288; 95% CI: (0.120-0.691), p = 0.005)], low income earners [(AOR = 0.452; 95% CI: (0.230-0.888), p = 0.021)], obesity [(AOR = 0.080; 95% CI: (0.019-0.347), p= 0.001)], heart failure [(AOR= 9.152; 95% CI: (2.325-41.266), p < 0.001)], atrial fibrillation [(AOR = 0.136; 95% CI: (0.068-0.891),p = 0.001)], tobacco smoking [(AOR = 0.350; 95% CI: (0.137-0.891), p = 0.028)], and poorly controlled blood pressure [(AOR = 0.107; 95% CI: (0.033-0.348), p <0.001)]. The mortality rate was 10.1%. Conclusion: The results of this study further support the argument on the higher prevalence of stroke admission in rural areas of Southwestern Nigeria. There may be need for public awareness on primary stroke prevention and early identification of the risk factors in order to reduce the prevalence and mortality of stroke in the rural Southwestern Nigeria.