{"title":"埃塞俄比亚西南部吉玛大学医学中心卒中单元收治患者的治疗结果及其决定因素","authors":"Ameha Zeleke Zewudie, Tolcha Regasa, Solomon Hambisa, Dejen Nureye, Yitagesu Mamo, Temesgen Aferu, Desalegn Feyissa, Tewodros Yosef","doi":"10.1155/2020/8817948","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC).</p><p><strong>Methods: </strong>A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1<sup>st</sup>, 2016 to March 30<sup>th</sup>, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with <i>P</i> value less than 0.05 were considered as statically significant determinants of poor treatment outcome.</p><p><strong>Results: </strong>Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, <i>P</i> = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, <i>P</i> < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, <i>P</i> < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, <i>P</i> = 0.03) were independent predictors of poor treatment outcomes.</p><p><strong>Conclusion: </strong>Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).</p>","PeriodicalId":22054,"journal":{"name":"Stroke Research and Treatment","volume":"2020 ","pages":"8817948"},"PeriodicalIF":1.8000,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790566/pdf/","citationCount":"5","resultStr":"{\"title\":\"Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia.\",\"authors\":\"Ameha Zeleke Zewudie, Tolcha Regasa, Solomon Hambisa, Dejen Nureye, Yitagesu Mamo, Temesgen Aferu, Desalegn Feyissa, Tewodros Yosef\",\"doi\":\"10.1155/2020/8817948\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC).</p><p><strong>Methods: </strong>A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1<sup>st</sup>, 2016 to March 30<sup>th</sup>, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with <i>P</i> value less than 0.05 were considered as statically significant determinants of poor treatment outcome.</p><p><strong>Results: </strong>Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, <i>P</i> = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, <i>P</i> < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, <i>P</i> < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, <i>P</i> = 0.03) were independent predictors of poor treatment outcomes.</p><p><strong>Conclusion: </strong>Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).</p>\",\"PeriodicalId\":22054,\"journal\":{\"name\":\"Stroke Research and Treatment\",\"volume\":\"2020 \",\"pages\":\"8817948\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2020-12-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790566/pdf/\",\"citationCount\":\"5\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Stroke Research and Treatment\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1155/2020/8817948\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2020/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"PERIPHERAL VASCULAR DISEASE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Stroke Research and Treatment","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1155/2020/8817948","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2020/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"PERIPHERAL VASCULAR DISEASE","Score":null,"Total":0}
引用次数: 5
摘要
背景:中风是埃塞俄比亚的一个公共卫生问题。尽管埃塞俄比亚的卒中发病率很高,但关于卒中的药物治疗、治疗结果和不良治疗结果的危险因素的数据缺乏。因此,本研究旨在评估Jimma University Medical Center (JUMC)卒中单元收治患者的治疗效果及其决定因素。方法:采用以医院为基础的回顾性横断面研究,对2016年2月1日至2018年3月30日吉马大学医学中心卒中单元收治的脑卒中患者病历进行分析。数据采用Epidata manager 4.0.2版本录入,SPSS 24版本分析。采用后向逐步回归方法进行多变量logistic回归分析,以确定卒中治疗效果不良的独立预测因素。P值小于0.05的变量被认为是不良治疗结果的统计学显著决定因素。结果:吉马大学住院的220例脑卒中患者中,男性占67.30%。近三分之二(63.18%)的患者治疗效果不佳。60%的患者使用了血脂异常药物,最常用的抗血小板药物是阿司匹林,67.3%的患者使用阿司匹林。年龄≥65岁调整奇数比(AOR): 2.56;95% CI: 1.95-9.86, P = 0.001),存在合并症(AOR: 5.25;95% CI: 1.08-17.69, P < 0.001),入院时伴有出血性卒中(AOR: 18.99;95% CI: 7.05-42.07, P < 0.001),卒中发生24小时后入院(AOR: 4.98;95% CI: 1.09-21.91, P = 0.03)是不良治疗结果的独立预测因子。结论:相当数量的脑卒中患者治疗效果较差。老年患者、诊断为出血性卒中的患者、合并症患者和延迟住院的患者更有可能出现不良的治疗结果。因此,应对上述患者进行频繁监测和护理。应提高对早期入院重要性的认识,特别是对有中风危险因素(心血管疾病)的患者。
Treatment Outcome and Its Determinants among Patients Admitted to Stroke Unit of Jimma University Medical Center, Southwest Ethiopia.
Background: Stroke is a public health problem in Ethiopia. Despite the high prevalence of stroke in Ethiopia, there is a paucity of data with regard to drug treatment, treatment outcome, and risk factors of poor treatment outcome of stroke. Hence, this study is aimed at assessing treatment outcome and its determinants among patients admitted to stroke unit of Jimma University Medical Center (JUMC).
Methods: A two-year hospital-based retrospective cross-sectional study was employed to analyze the medical records of patients admitted with stroke to stroke unit of Jimma University Medical Centre from February 1st, 2016 to March 30th, 2018. Data was entered by Epidata manager version 4.0.2 and analyzed by SPSS version 24. Multivariable logistic regression analysis with the backward stepwise approach was done to identify independent predictors of poor treatment outcome of stroke. Variables with P value less than 0.05 were considered as statically significant determinants of poor treatment outcome.
Results: Of 220 patients with stroke admitted to the Jimma University, 67.30% were male. Nearly two thirds (63.18%) of them had poor treatment outcomes. Dyslipidimics were administered to 60% of the patients, and the most popular antiplatelet used was aspirin, which was prescribed to 67.3% the patients. Age ≥ 65 adjusted odd ratio ((AOR): 2.56; 95% CI: 1.95-9.86, P = 0.001), presence of comorbidity (AOR: 5.25; 95% CI: 1.08-17.69, P < 0.001), admission with hemorrhagic stroke (AOR: 18.99; 95% CI: 7.05-42.07, P < 0.001), and admission to the hospital after 24 hour of stroke onset (AOR: 4.98; 95% CI: 1.09-21.91, P = 0.03) were independent predictors of poor treatment outcomes.
Conclusion: Substantial numbers of stroke patients had poor treatment outcomes. Elderly patients, patients diagnosed with hemorrhagic stroke, patients with comorbidity, and those with delayed hospital admission were more likely to have poor treatment outcome. Hence, frequent monitoring and care should be given for the aforementioned patients. Awareness creation on the importance of early admission should be delivered particularly for patients who have risk factors of stroke (cardiovascular diseases).