Medical complications and mortality of hospitalized stroke patients

Background: Stroke medical complications and mortality are not precisely known in northern Ethiopia. Hence, the main purpose of the study was to assess stroke medical complications, mortality and factors associated with mortality amongst stroke patients.

Methods: A cross sectional study design was used to conduct the study. Patients medical chart was reviewed to collect patient information. Patients medical registries who were diagnosed with stroke and treated in Ayder Comprehensive Specialized Hospital were retrospectively reviewed. Sample size was estimated using single population formula. Medical charts assigned a number and patients were selected using systematic random sampling technique. The data was analyzed using SPSS version 22. Using logistic regression analysis method, factors associated with mortality in the hospital were identified. A p value less than 0.05 were deemed to be significant in all types of analyses.

Results: About 216 stroke patients were studied and 126(58.3%) patients were women. A total of 48(22.2%) patients died in the hospital with median time to death of 3 days, ranged 1-48 days and average time to death of 6.2±8.7 days. One hundred thirty-six (62.9%) patients had at least one medical complication. The total frequency of complication was 234 in number and aspiration pneumonia (n=92, 39.4%) was the frequent complication. Patients with severe (1-8) (Adjusted Odds Ratio=26.48, 95%CI: 7.11-98.58, P<0.001) and moderate (9-12) (Adjusted Odds Ratio=3.88, 95%CI: 1.05-14.39), P=0.043) record of Glasgow Coma Scale at admission were 26 times and four times more likely to die than patients with mild Glasgow Coma Scale, respectively.

Conclusion: Substantially higher number of patients died at the hospital. Majority of the patients admitted to the hospital developed complication, aspiration pneumonia being the most frequently affirmed complication during their stay in the wards. Patients with severe and moderate Glasgow Coma Scale during admission were more likely to die at the hospital than patients with mild Glasgow Coma Scale. To precisely determine the mortality prevalence, medical complications frequency and to generalize the findings to the general population a multicenter prospective cohort study should be conducted.