IN-HOSPITAL MORTALITY AND ITS ASSOCIATED FACTORS AMONG HOSPITALIZED STROKE PATIENTS IN HARAR PUBLIC HOSPITALS, EASTERN ETHIOPIA

Abstract

Background: Stroke is rapidly developing clinical signs of focal or global disturbance of cerebral function, with symptoms lasting more than 24 hours and leading to death, with no apparent cause other than a pathological process of the blood vessel. Stroke is a public health problem in Ethiopia. According to World Health Organization data published in 2020, stroke deaths in Ethiopia reached 6.98% of total deaths. Despite the high stroke mortality rate in Ethiopia, there is nothing study about in-hospital mortality and its associated factors in eastern, Ethiopia. Objective: To determine in-hospital mortality and its associated factors among hospitalized stroke patients in Hiwot Fana comprehensive specialized university hospital and Jugal general hospital from September 2016–August 2022 G.C. Methods: A retrospective cohort study was conducted in Hiwot Fana comprehensive specialized university hospital and Jugal general hospital. A data collection tool was developed to record relevant information from existing medical records. The sample size of 395 medical records of stroke patients was selected from a total of 564 stroke patients by a simple random sampling technique. The data was entered by Epi Data Manager version 4.6 and analyzed by SPSS version 26. Bivariate and multivariate backward cox-regression analysis were used to verify the associated factors of in-hospital mortality among stroke patients. A p-value of 0.05 at a 95% confidence interval was used to establish a statistically significant association. Results: Of 395 hospitalized stroke patients assessed, 109 (27.6%) of them encountered death within the hospital while 57.2% and 15.2% of them were discharged with improvement and against medical advises, respectively. Age greater than 65 (AHR = 4.71, 95% CI = 1.11-19.96, p = 0.035), was statistically significant association with stroke mortality, while creatinine level >1.2 mg/dl (AHR = 1.54, 95% CI= 1.0-2.39, P = 0.05), and co-morbidity with atrial fibrillation (AHR = 1.48, 95% CI= 1.0-2.21, P = 0.05), where marginally significant association with stroke mortality. Conclusion: In-hospital mortality was found in more than a quarter of stroke patients. This mortality was high and more likely increased among the patients with age > 65, serum creatinine level >1.2 mg/dl, and co-morbidity with atrial fibrillation. Hence, this high-risk patients’ needs to be identified, monitored, followed-up, and aggressively treated to reduce mortality risks. Further prospective research should be conducted to investigate the problem in-depth.