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Mortality and recovery after stroke in The Gambia
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. For 1 year beginning April 1, 1990, any patient presenting...
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| Published in: | Stroke (1970) 2003-07, Vol.34 (7), p.1604-1609 |
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| container_end_page | 1609 |
| container_issue | 7 |
| container_start_page | 1604 |
| container_title | Stroke (1970) |
| container_volume | 34 |
| creator | WALKER, Richard W ROLFE, Michael KELLY, Peter J GEORGE, Melville O JAMES, Oliver F. W |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1161/01.STR.0000077943.63718.67 |
| format | article |
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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.
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.
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.</description><identifier>ISSN: 0039-2499</identifier><identifier>EISSN: 1524-4628</identifier><identifier>DOI: 10.1161/01.STR.0000077943.63718.67</identifier><identifier>PMID: 12817107</identifier><identifier>CODEN: SJCCA7</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Age Distribution ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Cause of Death ; Female ; Follow-Up Studies ; Gambia - epidemiology ; Hospital Mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Neurology ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Recovery of Function ; Stroke - diagnosis ; Stroke - mortality ; Survival Rate ; Vascular diseases and vascular malformations of the nervous system</subject><ispartof>Stroke (1970), 2003-07, Vol.34 (7), p.1604-1609</ispartof><rights>2003 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c433t-7d3cda72752541292b0056c2ca8d2fae4e1e48ec8ad44e5fc46868b9632920703</citedby><cites>FETCH-LOGICAL-c433t-7d3cda72752541292b0056c2ca8d2fae4e1e48ec8ad44e5fc46868b9632920703</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14962403$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12817107$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>WALKER, Richard W</creatorcontrib><creatorcontrib>ROLFE, Michael</creatorcontrib><creatorcontrib>KELLY, Peter J</creatorcontrib><creatorcontrib>GEORGE, Melville O</creatorcontrib><creatorcontrib>JAMES, Oliver F. W</creatorcontrib><title>Mortality and recovery after stroke in The Gambia</title><title>Stroke (1970)</title><addtitle>Stroke</addtitle><description>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.
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.
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.
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.</description><subject>Adult</subject><subject>Age Distribution</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cause of Death</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gambia - epidemiology</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Recovery of Function</subject><subject>Stroke - diagnosis</subject><subject>Stroke - mortality</subject><subject>Survival Rate</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0039-2499</issn><issn>1524-4628</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNpFkF1LwzAUhoMobk7_ghRB71pzkjRJvZOhU5gIOq9Dmp5itR8z6YT9eztX2Ll5OfC858BDyBXQBEDCLYXkffWW0N0olQmeSK5AJ1IdkSmkTMRCMn1MppTyLGYiyybkLISvAWdcp6dkAkyDAqqmBF4639u66reRbYvIo-t-0Q9L2aOPQu-7b4yqNlp9YrSwTV7Zc3JS2jrgxZgz8vH4sJo_xcvXxfP8fhk7wXkfq4K7wiqmUpYKYBnLKU2lY87qgpUWBQIKjU7bQghMSyekljrPJB9YqiifkZv93bXvfjYYetNUwWFd2xa7TTCKC64EqAG824POdyF4LM3aV431WwPU7IQZCmYQZg7CzL8wI3fly_HLJm-wOFRHQwNwPQI2OFuX3rauCgdOZJIJyvkf_tJyRg</recordid><startdate>20030701</startdate><enddate>20030701</enddate><creator>WALKER, Richard W</creator><creator>ROLFE, Michael</creator><creator>KELLY, Peter J</creator><creator>GEORGE, Melville O</creator><creator>JAMES, Oliver F. W</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20030701</creationdate><title>Mortality and recovery after stroke in The Gambia</title><author>WALKER, Richard W ; ROLFE, Michael ; KELLY, Peter J ; GEORGE, Melville O ; JAMES, Oliver F. W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c433t-7d3cda72752541292b0056c2ca8d2fae4e1e48ec8ad44e5fc46868b9632920703</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Adult</topic><topic>Age Distribution</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cause of Death</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gambia - epidemiology</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Recovery of Function</topic><topic>Stroke - diagnosis</topic><topic>Stroke - mortality</topic><topic>Survival Rate</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>WALKER, Richard W</creatorcontrib><creatorcontrib>ROLFE, Michael</creatorcontrib><creatorcontrib>KELLY, Peter J</creatorcontrib><creatorcontrib>GEORGE, Melville O</creatorcontrib><creatorcontrib>JAMES, Oliver F. W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Stroke (1970)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>WALKER, Richard W</au><au>ROLFE, Michael</au><au>KELLY, Peter J</au><au>GEORGE, Melville O</au><au>JAMES, Oliver F. W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Mortality and recovery after stroke in The Gambia</atitle><jtitle>Stroke (1970)</jtitle><addtitle>Stroke</addtitle><date>2003-07-01</date><risdate>2003</risdate><volume>34</volume><issue>7</issue><spage>1604</spage><epage>1609</epage><pages>1604-1609</pages><issn>0039-2499</issn><eissn>1524-4628</eissn><coden>SJCCA7</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>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.
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.
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.
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.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12817107</pmid><doi>10.1161/01.STR.0000077943.63718.67</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Stroke (1970), 2003-07, Vol.34 (7), p.1604-1609 |
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| language | eng |
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| subjects | Adult Age Distribution Aged Aged, 80 and over Biological and medical sciences Cause of Death Female Follow-Up Studies Gambia - epidemiology Hospital Mortality Humans Male Medical sciences Middle Aged Neurology Prognosis Proportional Hazards Models Prospective Studies Recovery of Function Stroke - diagnosis Stroke - mortality Survival Rate Vascular diseases and vascular malformations of the nervous system |
| title | Mortality and recovery after stroke in The Gambia |
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