Mortality and recovery after stroke in The Gambia

Hdl Handle:
http://hdl.handle.net/10149/58287
Title:
Mortality and recovery after stroke in The Gambia
Authors:
Walker, R. W. (Richard); Rolfe, M. (Michael); Kelly, P. J. (Peter); George, M. O. (Melville); James, O. F. W. (Oliver)
Affiliation:
North Tyneside General Hospital. Department of Medicine; Withybush General Hospital. Department of Medicine. Pembrokeshire; Tees Health Authority; WHO Country Office. Ghana; University of Newcastle Upon Tyne. Medical School. Department of Medicine.
Citation:
Walker, R. W. et al. (2003) 'Mortality and recovery after stroke in The Gambia', Stroke, 34 (7), pp.1604-9.
Publisher:
American Heart Association
Journal:
Stroke
Issue Date:
2003
URI:
http://hdl.handle.net/10149/58287
DOI:
10.1161/01.STR.0000077943.63718.67
Abstract:
Background and Purpose: There are no previously published studies of the long-term outcome of stroke in sub-Saharan Africa. Our goal was to determine the case fatality, time to and cause of death, and recovery in a hospital cohort of stroke patients in The Gambia. Methods: For 1 year beginning April 1, 1990, any patient presenting to the Royal Victoria Hospital (Banjul) with a diagnosis of stroke or having a stroke as an inpatient was recruited. After a standardized assessment, patients were followed up at 1 month, 6 months, and 3 to 4 years to assess recovery or, for those who died, record the date and likely cause of death. Results: Mean age of the 106 patients (70 men) was 58 years (range, 20 to 93 years). By 1 and 6 months, 29 (27%) and 47 (44%), respectively, had died, with only 27 (25%) surviving to final follow-up (4 patients not traced). Death occurred in hospital in 43 patients (57%). Cause of death was the initial stroke in 46 (61%), further stroke in 5 (7%), infection in 9 (12%), miscellaneous in 8 (11%) (only 1 vascular), and unknown in 7 (9%). On Cox regression analysis, incontinence in the first 24 hours, sensory inattention, and impaired gag reflex on admission were significant predictors of mortality. Predictors of recovery were similar to those of developed countries. Conclusions: Despite the young mean age, there was a high case fatality rate. The main cause of death was the stroke itself, and ischemic heart disease was very rare.
Type:
Article
Keywords:
sub-Saharan Africa; Africa; The Gambia; fatality; stroke; recovery; mortality; ischemic heart disease
ISSN:
1524-4628
Rights:
Subject to restrictions, author can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 14/01/2010]
Citation Count:
27 [Scopus, 14/01/2010]

Full metadata record

DC FieldValue Language
dc.contributor.authorWalker, R. W. (Richard)-
dc.contributor.authorRolfe, M. (Michael)-
dc.contributor.authorKelly, P. J. (Peter)-
dc.contributor.authorGeorge, M. O. (Melville)-
dc.contributor.authorJames, O. F. W. (Oliver)-
dc.date.accessioned2009-04-01T10:48:05Z-
dc.date.available2009-04-01T10:48:05Z-
dc.date.issued2003-
dc.identifier.citationStroke; 34 (7): 1604-9-
dc.identifier.issn1524-4628-
dc.identifier.doi10.1161/01.STR.0000077943.63718.67-
dc.identifier.urihttp://hdl.handle.net/10149/58287-
dc.description.abstractBackground and Purpose: There are no previously published studies of the long-term outcome of stroke in sub-Saharan Africa. Our goal was to determine the case fatality, time to and cause of death, and recovery in a hospital cohort of stroke patients in The Gambia. Methods: For 1 year beginning April 1, 1990, any patient presenting to the Royal Victoria Hospital (Banjul) with a diagnosis of stroke or having a stroke as an inpatient was recruited. After a standardized assessment, patients were followed up at 1 month, 6 months, and 3 to 4 years to assess recovery or, for those who died, record the date and likely cause of death. Results: Mean age of the 106 patients (70 men) was 58 years (range, 20 to 93 years). By 1 and 6 months, 29 (27%) and 47 (44%), respectively, had died, with only 27 (25%) surviving to final follow-up (4 patients not traced). Death occurred in hospital in 43 patients (57%). Cause of death was the initial stroke in 46 (61%), further stroke in 5 (7%), infection in 9 (12%), miscellaneous in 8 (11%) (only 1 vascular), and unknown in 7 (9%). On Cox regression analysis, incontinence in the first 24 hours, sensory inattention, and impaired gag reflex on admission were significant predictors of mortality. Predictors of recovery were similar to those of developed countries. Conclusions: Despite the young mean age, there was a high case fatality rate. The main cause of death was the stroke itself, and ischemic heart disease was very rare.-
dc.publisherAmerican Heart Association-
dc.rightsSubject to restrictions, author can archive publisher's version/PDF. For full details see http://www.sherpa.ac.uk/romeo/ [Accessed 14/01/2010]-
dc.subjectsub-Saharan Africa-
dc.subjectAfrica-
dc.subjectThe Gambia-
dc.subjectfatality-
dc.subjectstroke-
dc.subjectrecovery-
dc.subjectmortality-
dc.subjectischemic heart disease-
dc.titleMortality and recovery after stroke in The Gambia-
dc.typeArticle-
dc.contributor.departmentNorth Tyneside General Hospital. Department of Medicine; Withybush General Hospital. Department of Medicine. Pembrokeshire; Tees Health Authority; WHO Country Office. Ghana; University of Newcastle Upon Tyne. Medical School. Department of Medicine.-
dc.identifier.journalStroke-
ref.assessmentRAE 2008-
ref.citationcount27 [Scopus, 14/01/2010]-
or.citation.harvardWalker, R. W. et al. (2003) 'Mortality and recovery after stroke in The Gambia', Stroke, 34 (7), pp.1604-9.-
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