DETERMINANTS OF THE STROKE AMONG YOUNG ADULT PATIENTS ADMITTED TO HIWOT FANA SPECIALIZED UNIVERSITY HOSPITAL, HARAR: A HOSPITAL BASED CASE CONTROL STUDY

Abstract

Background: Stroke is the second leading cause of death above the age of 60 years, and the fifth leading cause in people aged 15 to 59 years old as reported by the World Health Organization global burden of diseases. Stroke in the young is particularly tragic because of the potential to create long-term disability, burden on the victims, their families, and the community at large. Despite this, there is limited data on stroke in young adults, and its risk factors in Ethiopia. Objective: to assess risk factors and subtypes of the stroke among young adults at Hiwot Fana Specialized University Hospital. Methods: A hospital-based case-control study was conducted among young adult patients admitted to medical or neurology ward of Hiwot-Fana Specialized University Hospital, from January 1, 2017 to August 30, 2022. Cases were a brain Computerized Tomography scan confirmed stroke patient whereas controls were non-stroke patient who were admitted to medical ward or neurology ward during study period. To determine risk factors for stroke, binary logistic regression was applied. Odds ratio (with 95% confidence interval) was used as a measure for associations, and variables with a p-value of ≤0.05 were considered as statistically significant. Results: Among 70 patients with stroke, 37(52.9%) had ischemic stroke and 33(47.1%) had hemorrhagic stroke. The mean age was 35.9 years (SD 7.4) for stroke patients (cases) and 28.7 years (SD 6.9) for controls. Male patients were predominant with 70% in cases and 50% in controls. Hypertension, with an Adjusted odd ratio of 23.09 (95% CI 9.895-54.056), cigarette smoking, with an Adjusted odd ratio of 5.66 (95% CI 1.70–18.841) and age (31-45) with an Adjusted odd ratio of 3.24 (95% CI,1.42-7.40) were found to be determinants of the stroke in young adult. There was no statistically significant association with diabetes, Cardiac disease, Atrial fibrillation, Human Immuno- deficiency virus infection and Central nervous system infection. Conclusion: Hypertension, cigar rete smoking and older age (31-45) were independent risk factors of the stroke among young adult patient admitted to Hiwot-fana specialized university hospital. Among young adults with the stroke, ischemic stroke was slightly higher than hemorrhagic stroke. New strategies and interventions which focus on prevention of hypertension and cigarette smoking among young adult will be important to reduce the burdens of the stroke among young adult until further information on risk factors of the stroke in young adult explored in Ethiopia.